Care practices during pregnancy, infant feeding practices and their association with nutritional status of infants in Gujarat, India

Background: Infant feeding practices plays an important role in nutritional status of children. Aims & Objectives: To assess ante-natal care, delivery and infant feeding practices and their association with nutritional status. Material & Methods: A community-based, cross-sectional study was carried out in all the districts using systematic random sampling. Information was collected from the selected household on socio-demographic, delivery and feeding practices and anthropometric measurements were carried out. Nutritional status was assessed using WHO Child Growth Standard. Proportion test, bivariate and multivariate regression analysis was done. Results: The overall prevalence of underweight, stunting and wasting was 26%, 21.5% and 16.5% respectively. Logistic regression analysis showed that the risk of underweight and stunting was 1.4-1.5 times higher among infant whose mother had undergone ≤3 ANCs or not availed ANCs, 1.4 times higher among infants delivered at home, having morbidity during previous fortnight and 3.6 times higher among low birth weight children. The risk of underweight and wasting was 1.2 times higher among infants with birth interval less than 2 years and 1.3-1.5 times higher among children whose mothers were washing their hands only with water after defecation. Conclusion: The undernutrition is associated with ante-natal care, delivery practices, low birth weight and hygienic practices.

Impact of feeding and breastfeeding practices on the nutritional status of infants in a district of Andhra Pradesh, India

Background. Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. We did a cross-sectional household study to assess feeding practices of infants and young children in rural areas of Medak district, Andhra Pradesh. Methods. A total of 805 child–mother pairs were included using systematic random sampling. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and sociodemographic factors as independent variables. Results. Breastfeeding was universal in the study area. Only 22% of mothers initiated breastfeeding within one hour whereas 44% initiated it within three hours after delivery. The median duration of exclusive breastfeeding was 5.5 months. Pre-lacteal use was high (44.7%). Only 41% of infants were exclusively breastfed for 6 months and 58% of infants (6–11 months) received complementary feeding at 6–9 months of age. Timely initiation of breastfeeding and exclusive breastfeeding for 6 months was significantly more likely among mothers belonging to scheduled castes and scheduled tribes (OR 0.27, 95% CI 0.10–0.76 and OR 0.24, 95% CI 0.08–0.76). Timely initiation of complementary feeding was more likely among scheduled caste and scheduled tribe communities (OR 0.24, 95% CI 0.11–0.54). Conclusion. Early initiation of breastfeeding (within an hour of birth) and other feeding practices were associated with community, type of family and education of mother. Efforts are needed to promote early initiation of breastfeeding, exclusive breastfeeding for 6 months and age-appropriate complementary feeding among infants.

Prevalence of & knowledge, attitude & practices towards HIV & sexually transmitted infections (STIs) among female sex workers (FSWs) in Andhra Pradesh.

Background & objectives: As part of the baseline survey carried out during 2005-06, biological and behavioural data were generated on about 3200 female sex workers (FSWs), from eight districts of Andhra Pradesh (AP), India. This study describes the relationship between socio-demographic and behavioural factors with consistent condom use (CCU) and HIV among FSWs in AP. Methods: A cross-sectional community-based study was conducted among female sex workers (FSW) in eight districts of Andhra Pradesh, India, using conventional cluster sampling and time-location cluster sampling. Key risk behaviours and STIs related to the spread of HIV were assessed. Blood samples were collected to detect syphilis, Herpes simplex virus type 2 (HSV-2) Chlamydia trachomatis (CT), Neiserria gonorrhoeae (NG) and HIV serology. Results: About 70 per cent of the FSWs were illiterates, nearly 50 per cent were currently married and 41 per cent of the FSWs had sex work as the sole source of income. More than 95 per cent of the FSWs heard of HIV, but about 99 per cent believed that HIV/AIDS cannot be prevented. Logistic regression analysis showed significantly lesser CCU with high client volume, not carrying condom and could not use condom in past 1 month due to various reasons such as non co-operation by the clients. Similarly, CCU was significantly (P<0.001) lesser (only 8.9%) with regular non-commercial partners. Overall there was 16.3 per cent prevalence of HIV amongst FSWs. C. trachomatis and N. gonorrheae were prevalent in 3.4 and 2 per cent of the FSWs, respectively and about 70 per cent of the FSWs were positive for HSV2 serology. HIV was significantly associated with STIs. Interpretation & conclusions: Misconception that HIV/AIDS cannot be prevented is very high. Most of the subjects in the present study had first sexual debut at a very young age. HIV was associated with STIs, emphasizing aggressive STI diagnosis and treatment. CCU must be emphasized right from first sexual debut with all clients and non-commercial partners as well.

Application of Factor Analysis to Identify Dietary Patterns and Use of Factor Scores to Study Their Relationship with Nutritional Status of Adult Rural Populations.

The prevalence of chronic energy deficiency (CED) among one-third of the Indian population is attributed to inadequacy of consumption of nutrients. However, considering the complexity of diets among Indians, the relationship between a particular dietary pattern and the nutritional status of the population has not been established so far. A community-based cross-sectional study was undertaken to assess estimates, at district level, of diet and nutritional status in Orissa State, India. Factor analysis was used for exploring the existence of consumption pattern of food and nutrients and their relationship with the nutritional status of rural adult population. Data on 2,864 adult men and 3,525 adult women in Orissa state revealed that there exists six patterns among food-groups explaining 59% of the total variation and three patterns among nutrients that explain 73% of the total variation among both adult men and women. The discriminant function analysis revealed that, overall, 53% of the men were correctly classified as either with chronic energy deficiency (CED) or without CED. Similarly, overall, 54% of the women were correctly classified as either with CED or without CED. The sensitivity of the model was 65% for both men and women, and the specificity was 46% and 41% respectively for men and women. In the case of classification of overweight/ obesity, the prediction of the model was about 75% among both men and women, along with high sensitivity. Using factor analysis, the dietary patterns were identified from the food and nutrient intake data. There exists a strong relationship between the dietary patterns and the nutritional status of rural adults. These results will help identify the community people with CED and help planners formulate nutritional interventions accordingly.

Humoral immunological profile of workers exposed to asbestos in asbestos mines.

Humoral immunological profile including immunoglobulins IgG, IgA, IgM, C-reactive protein, rheumatoid factor, antinuclear antibodies and circulating immune complexes were studied in a representative sample of 36 workers suffering from asbestosis (group A), 35 workers who are exposed to asbestos but not having evidence of asbestosis (group B) and 28 control workers (group C). Mean IgG and IgA levels were found to be significantly higher in the two exposed groups than in the controls. Circulating immune complexes of IgG, IgA and IgM class were detected in a significant percentage of cases in exposed groups than in controls. In groups A and B, the percentage of positive ANF cases was much higher than in the controls. The results suggest that immunological changes are associated with exposure to asbestos and these may play an important role in the pathogenesis of the disease process.