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Objective:To provide the regional pediatric cancer (age-group 0-14 years) burden and pattern in India utilizing published data of population-based cancer registries established under the National Cancer Registry Programme and Tata Memorial Centre, Mumbai. Methods:Based on the geographic locations, the population-based cancer registries were categorized into six regions. The age-specific incidence rate was calculated using the number of pediatric cancer cases and population in the respective age-group. Age-standardized incidence rate per million and 95% CI were calculated.Results: In India, 2% of all cases were pediatric cancer. The agestandardized incidence rate (95% CI) for boys and girls is 95.1 (94.3-95.9) and 65.5 (64.8-66.2) per million population, respectively. Registries from northern India reported the highest rate; while the lowest rate was in northeastern India. Conclusion:There is a need to establish pediatric cancer registries in different regions of India to know the accurate pediatric cancer burden.
ABSTRACT
Background & objectives: There are no active surveillance studies reported from South East Asian Region to document the impact of change in socio-economic state on the prevalence of rheumatic fever/rheumatic heart disease (RF/RHD) in children. Therefore, we conducted a study to determine the epidemiological trends of RF/RHD in school children of Shimla city and adjoining suburbs in north India and its association with change in socio-economic status. Methods : Active surveillance studies were conducted in 2007-2008 in urban and rural areas of Shimla, and 15145 school children, aged 5-15 yr were included and identical screening methodology as used in earlier similar survey conducted in 1992-1993 was used. The study samples were selected from schools of Shimla city and adjoining rural areas by multistage stratified cluster sampling method in both survey studies. After a relevant history and clinical examination by trained doctor, echocardiographic evaluation of suspected cases was done. An updated Jones (1992) criterion was used to diagnose cases of acute rheumatic fever (ARF) and identical 2D-morphological and Doppler criteria were used to diagnose RHD in both the survey studies. The socio-economic and healthcare transitions of study area were assessed during the study interval period. Results: Time trends of prevalence of RF/RHD revealed about five-fold decline from 2.98/1000 (95% C.I. 2.24-3.72/1000) in 1992-1993 to 0.59/1000 (95% C.I. 0.22-0.96/1000) in 2007-2008. (P<0.0001). While the prevalence of ARF and RHD with recurrence of activity was 0.176/1000 and 0.53/1000, respectively in 1992-1993, no case of RF was recorded in 2007-2008 study. Prevalence of RF/RHD was about two- fold higher in rural school children than urban school children in both the survey studies (4.42/1000 vs. 2.12/1000) and (0.88/1000 vs. 0.41/1000), respectively. The indices of socio-economic development revealed substantial improvement during this interim period. Interpretation & conclusions: The prevalence of RF/RHD has declined by five-fold over last 15 yr and appears to be largely contributed by improvement in socio-economic status and healthcare delivery systems. However, the role of change in the rheumatogenic characteristics of the streptococcal stains in the study area over a period of time in decline of RF/RHD cannot be ruled out. Policy interventions to improve living standards, existing healthcare facilities and awareness can go a long way in reducing the morbidity and mortality burden of RF/RHD in developing countries.
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Decline in malnutrition levels has been dismal since the 1990s. We ascertained decadal trend in childhood nutritional status between 1997 and 2007 in Chandigarh, India and assessed impact of Integrated Child Development Services (ICDS) on childhood undernutrition. A total of 803 under-five children, 547 children between 12-23 months age, and 218 women with an infant child were recruited for the study. Findings of present study were compared with another methodologically similar study (1997) from Chandigarh and Reproductive and Child Health Rapid Household Survey (1998) to draw decadal trends. Prevalence of underweight among under-five children remained almost stagnant in the last one decade from 51.6% (1997) to 50.4% (2007). There was insignificant difference (P=0.3) in prevalence of underweight among children registered under ICDS program (52.1%) and those not registered (48.4%) in 2007. Other health and service provision indicators had mixed results in the past decade. Health services utilization was poorest in urban slums.
ABSTRACT
A cross-sectional study was conducted in Chandigarh Union Territory to evaluate the performance of an audio-assisted confidential voting interview (AVI), for assessing the sexual behavior among young adults aged 20 - 34 years. Using systematic random sampling 625 males and 630 females were interviewed alternately, either by AVI or by face-to-face interview (FFI). More men revealed having sex with men in AVI (2.6%) than FFI (0.6%) (P 0.06). Women reported having sex with non-regular partners more often in AVI (4.8%) compared to FFI (0.3%) (P < 0.001). AVI performed better than FFI for eliciting sensitive sexual behaviors.