Knowledge about Transmission Dynamics of Sexually Transmitted Infections.

Background : Sexually transmitted infections (STIs) disproportionately affect women who also bear much more severe morbidity, get severe consequences if not treated and even transmit disease to offsprings during pregnancy. Improving awareness and knowledge of STIs is a key for prevention but majority females don’t have this information making them more susceptible to STIs and reinfections. Objectives : To determine the awareness and level of knowledge about transmission dynamics of STI among the female patients attending Gynecology out-patient department and to assess the various factors related with it. Methodology : Cross-sectional study was conducted among female patients presenting to Gynecology OPD of a tertiary hospital in Delhi with signs and symptoms suggestive of STIs. Exit interview of 100 patients was done by using a pretested structured questionnaire. Knowledge level was graded into Poor knowledge (0-8) and Good knowledge (9-16) on a 16-point score card. Chi square was applied. Results : Only 62 (62%) patients had heard about STIs. The fact that STIs can be prevented by abstinence, being faithful and condoms was known to 25 (25%), 35 (35%) and 28 (28%) patients respectively. Only 21 (21%) patients had good knowledge, significantly more among literates and working females. Reinfection was reported by 9 (9%) patients and it was significantly more in migrants. Conclusion Knowledge of respondents about STIs is very low, particularly among illiterates and housewives. There is a potential to control STIs by making females aware of the uses of condom. Reinfection was significantly more in migrants, so there is a need to focus IEC services to migrants.

Prevalence of major neurological disorders among geriatric population in the metropolitan city of Kolkata.

Well-conducted neuroepidemiological studies for the geriatric population are rare in India. In view of the growing aging population, we planned to determine the prevalence of common neurological disorders among the elderly population in the city of Kolkata. This was a cross-sectional study of a stratified random sample of the city population and carried in two stages through house to house survey. Initially, trained non-medical workers screened the cases with a validated family questionnaire and then a neurologist examined all the screened positive cases. A validated neuropsychological screening test was also applied among the elderly population with cognitive complaints. Results showed prevalence rates (per 1000 elderly population--> or = 60 years) of following disorders in decreasing order: stroke--33.93, essential tremor--13.76, dementia--7.89, Parkinsonism--3.30 and epilepsy--2.57. Sex-specific prevalence showed that stroke was commoner among men and that of other disorders among women. Age-specific prevalence recorded progressive increase in the rates of all disorders among both genders, though not uniformly among women. Overall the crude prevalence of neurological disorders was 60.9 per 1000. The present study shows higher rate of stroke as compared to other neurological disorders among elderly population in India, which needs urgent attention.

Anthropometric correlates of adolescent blood pressure.

A community based cross-sectional study was undertaken among 1081 adolescents to assess the relationship of adolescent blood pressure with weight, height and BMI in Chetla, Kolkata; data collection was done with a predesigned schedule along with recording of anthropometric measurements and blood pressure. Mean, correlation coefficient was used for statistical analysis. Systolic and diastolic blood pressure of both sexes increased with increase in weight, height and BMI with a significant positive linear correlation. Life style modification should be stressed upon from childhood.

A random sample survey for prevalence of major neurological disorders in Kolkata.

BACKGROUND & OBJECTIVES: Large scale epidemiological studies on neurological disorders are very few in India. We therefore planned to conduct a cross-sectional population-based epidemiological study on a stratified randomly selected sample from the city of Kolkata to study the prevalence of major neurological disorders such as epilepsy, stroke, dementia and Parkinsonism. METHODS: The method of case ascertainment was two- stage house-to-house survey; the first stage was undertaken by a field team consisting of four field workers and a neuropsychologist. Screening questionnaire based on National Institute of Mental Health and Neuro Sciences (NIMHANS) protocol was used. In the second stage a neurologist examined all the screened positive cases. RESULTS: A total of 52,377 subjects participated in the study. The crude prevalence rates (per 100,000 population) of major neurological disorders with 95 per cent confidence intervals (95% CI) and age adjusted rates (AAR) based on US 2000 population were 557.5 (95% CI 496.17-624.40 and AAR - 516.77) in epilepsy, 486.85 (95% CI 377.0 to 551.11 and AAR-765.68) in stroke, 87.82 (95% CI 64.02-117.50 and AAR-168.4) in dementia and 45.82 (95% CI 29.64-67.63 and AAR-71.64) in Parkinsonism. The weighted prevalence rates (per 100,000) of the whole population based on re-screening of 10 per cent of negative samples were 763.89 (95% CI 690.55- 842.57) in epilepsy, 624.32 (95% CI 555.64-699.24) in stroke and 139.37 (95% CI 108.71-176.06) in dementia. INTERPRETATION & CONCLUSION: A high rate of stroke and overall lower prevalence of Parkinsonism and dementia was recorded as compared to western studies. High prevalence rate of stroke emphasizes the need to study incidence, morbidity and mortality profile of stroke including its socio-economic impact and also case-control analysis to determine the underlying risk factors.

A study of HIV/STD infections amongst commercial sex workers in Kolkata. (India) Part-IV laboratory investigation of STD and HIV infections.

Out of 867 sex workers examined during 1998-2000 from the five important red light areas of Kolkata, 26.18%(227) were suffering from active syphilitic infection having positive VDRL test with titre 1/8 and above. Vaginal smear for gram staining was collected from all sex workers, and found positive for active gonorrhoeal infection in 41.8% (362). Culture positivity for gonorrheal infection was 34.14% (296). Sex workers were also having other STD infection, 23.64% (205) Trichomonas infection, 13.26% (115) Candidiasis, 8.77% (76), Gardenella and 3.0% (26) Chanchroid for which vaginal samples were found positive. HIV sero-positivity was found to be 13.2% (115) out of 867 blood samples examined from all sex workers under study. There were 0.34% (3) sex workers who were also positive for HIV II infection along with HIV-I infection. A case of HIV II alone was not detected in any of the sex workers. Around 49.6% (430) knew that STD/HIV can be prevented by use of condom. However, condom was used by only 6.57% (57) sex workers.

A study of HIV/STD infections amongst commercial sex workers in Kolkata (India). Part-III, clinical features of sexually transmitted diseases.

The clinical features of sexually transmitted disease (STD) infection in female sex workers found in a community based study in different red light areas of Kolkata are discussed in this paper. Out of 867 sex workers clinically examined in the clinics in their respective areas, 80.16% were having different signs and symptoms of sexually transmitted diseases. The vaginal discharge was the commonest feature present in 49.6% sex workers. The chronic vaginal discharge of more than a month was found in 47.44%, while 37.90% sex workers had vaginal discharge of less than one month. The genital ulcer was present in 25.03% (217) sex workers. The other sexually transmitted infection that was found includes genital warts 13.73%, scabies 12.11 and Inguinal bubo in 1.73% sex workers. The sex workers were also having other symptoms e.g. chronic weight loss, prolonged fever and chronic diarrhoea in 13.73% (119), 10.03% (87) and in 1.96% (17) sex workers respectively.

A study of Hiv/STD infections amongst commercial sex workers in Kolkata (India). Part-II: sexual behaviour, knowledge and attitude towards STD/HIV infections.

The sexual behaviour, knowledge, attitude and practice for prevention and control measures against STD/HIV are discussed in this paper. In all 867 sex workers, belonging to different red light areas of Kolkata viz. Sonagachi 77.28% (670), Metiabruz 14.07% (122) and 8.65% (75) from Rampurgali, Khidderpore and Bow Bazar were studied. Majority of sex workers 74.28% (644) were under thirty years of age. Around 22.26% (193) were within 20 years and 5.85%(51) were above 40 years of age. Sex workers had more than one habit but commonest were betel nut chewing in 67.59%(586) and alcohol consumption either alone or with the clients in 61.1% (529). Drug abuse (IVD) was not agreed to by any of the sex workers. Around 78.09% (677) were in the trade for last ten years, and 21.91%(190) for more than ten years. The mean duration for which sex workers remain in the trade is 6.71 years. The average number of clients visiting them were 2.67 per sex workers per day. The commonest sexual practice was normal peno-vaginal in 94.1 % (823). Peno-oral sex is practiced by 32.5%(282) sex workers, of which 2.65 % (23) always, 2.31%(20) often and 27.0%(59) sometimes practiced it. Peno-rectal sex was practiced by 5.42% (47), with 2.31% (20) often and 3.11% (27) sometimes. Around 13.96% (121) sex workers participate in the group sex. The knowledge of STD/HIV infection was quite low, 49.48% (429) of CSWs had heard about STD/HIV/AIDS and around 49.6% (430) knew that STD/HIV could be prevented by condom use.

A study of HIV/STD infections amongst commercial sex workers in Kolkata (India). Part-I: some socio-demographic features of commercial sex workers.

A community-based survey of Human Immunodeficiency Virus (HIV) and sexually transmitted diseases (STD) was carried out among commercial sex worker's (CSW) in different red light areas of Kolkata. By multistage random sampling technique 867 female sex workers (FSW) studied who were belonging to Sonagachi 77.28%, Metiabruz 14.07%, Rampurgali and Khidderpore 8.65% red light areas. Among sex workers surveyed 58.94% were Hindu and 33.33% Muslims. There were 22.07% CSW of foreign origin, out of which 17.99% from Bangladesh and 4.04% from Nepal. Majority of CSW 74.28% were under thirty years of age. The lowest age was 13 years and mean age was 26.55 years. There were 22.26% sex workers under twenty years and 6.92% above forty years of age. About 79.0% of sex workers were illiterate. The average number of clients visiting each sex workers was 2.67, with a range between 1 to 8 clients per day. The average duration for which sex workers remain in the trade was 6 to 7 years. Around 60.09% sex workers were in the trade for five years, while 2.64% were for more than twenty years. Average monthly income of sex workers was around Rs. 500-1000. History of pregnancy was present in 84.66% with one child in 24.91 % to maximum eight in 0.23% sex workers. The mean number of pregnancies was 1.9 per female sex workers. About 36.2% had history of abortion and 65.51 % had living children.

Patterns of tobacco use amongst school teachers.

Indulgence in tobacco is a known health risk. The example of school teachers in this regard is likely to have far reaching influence on their pupils and the community. A cross sectional study among 257 teachers from 30 schools revealed that as high as 51.0% teachers consumed tobacco in one form or the other. Smoking was the most popular form of tobacco use (72%). Marked gender differences were noted with 73.9%. Male teachers hooked to tobacco habit in comparison to 13.9% of female teachers. Educational qualification had paradoxical effect on tobacco habit as fewer (20.0%) graduate teachers used tobacco in comparison to non graduate teachers (55.7%). However proportion of Post graduate teachers consuming tobacco was still higher (64.2%). Initiation to tobacco habit in majority began at age 21 years and beyond. Common reasons given for tobacco consumption were curiosity (37.9%), to be social (22.0%), enjoyment (21.2%), to relieve stress (8.17%) and improving performance (5.8%). 21.9% smokers consumed more than 20 cigarettes a day. More than four fifth teachers consciously avoided tobacco use in school premises. Nearly half (45.3%) of tobacco users reported reduction in tobacco use in preceding two years. By and large teachers (92.4%) were aware of harmful consequences of tobacco on health. But only in 29.6% it was a cause for concern. 71.2% respondents intended to give up tobacco habit. 33.7% smokers were aware of hazards of passive smoking to others.