Prevalence of psychological morbidity and its correlates among school-going adolescents of urban Puducherry, India

BACKGROUND Experiencing poor mental health during adolescence predisposes an individual to psychiatric morbid conditions in adulthood. We estimated the prevalence of psychological morbidity and its associated factors, among school-going adolescents in higher secondary schools of urban Puducherry. METHODS We did this cross-sectional study among adolescents studying in classes 11 and 12 from selected schools of urban Puducherry, including one government and three private schools. Study tools used were the General Health Questionnaire-12 and Perceived Stress Scale-10 to assess psychological morbidity and perceived psychological stress in adolescents, respectively. Risk factors in academic, environmental, personal and health-related domains were captured using a structured questionnaire. Study questionnaires were self-administered by the participants in classrooms. Bivariate and multivariate analyses were done to identify risk factors for psychological morbidity. RESULTS Of the 820 adolescents surveyed, the prevalence of psychological morbidity was 25.4% (95% CI 22.4– 28.5). Academic factors such as reporting peer pressure for academic performance and lack of extracurricular activities at school were associated with psychological morbidity. Among health-related factors, adolescents who reported having difficulty in coping with pubertal changes, being worried about their physical appearance, reporting substance abuse and experiencing sleep disturbances had greater chances of having screened with psychological morbidity. Of note, adolescents with psychological stress had 2.5 times higher chances of having psychological morbidity. CONCLUSIONS We estimated that 1 in 4 school-going adolescents in urban Puducherry suffered psychological morbidity. Reducing the academic burden and advocating health promotion through a life skills approach may improve mental wellness in Indian adolescents.

Wound management and vaccination following animal bite: a study on knowledge and practice among people in an urban area of Pondicherry, India.

Background: Correct wound management and vaccination following animal bite prerequisite for prevention of rabies. Objective: To find out knowledge and practice about the correct wound management and vaccination following animal bite among the individuals in a selected urban area of Pondicherry. Methods: This explorative study was conducted in the field practice area of a tertiary care institution in urban Pondicherry. A total of 156 individuals one each from 156 households were selected and included after obtaining verbal informed consent. Using a pretested semi structured questionnaire, we obtained information on knowledge about wound care following animal bite and vaccination against rabies, and details of animal bite to any household members anytime in the past. Results: Only 19% of the respondents could name “Rabies” as the cause of death following animal bite. All the respondents had known about immediate initiation of anti-rabies vaccine following animal bite and its free availability in government hospitals. However, only one third of the respondents were aware of immediate washing of wound with soap and water following animal bite. The last one year incidence of animal bite was found to be 0.87% (6/682). Majority of the animal bite cases belonged to Class II (58%) and, involved dogs (88%), males (79.2%) and people from low socio-economic status (96%). All the individuals with animal bites had initiated anti-rabies vaccine within 24 hours of bite, however only two third had washed their wound with soap and water immediately following animal bite. About 17% of the animal bite victims had applied oil or turmeric over the wound. Conclusions: Incorrect immediate wound care following animal bite is a concern for prevention of rabies in this area. Health education should be strengthened on certain aspects like disease causation, wound care following animal bite and before coming in contact with a health facility to this population.

Iron-Folic Acid Intake Among Pregnant Women in Anumanthai PHC of Villupuram, Tamil Nadu.

Background: Prevalence of anemia in India is among the highest in the world. Apart from other causes of anemia, iron or folate deficiency is the most common cause, especially during pregnancy. Although, supplementation of diet with iron and folic acid (IFA) tablets has been a part of the Ministry of Health and Family Welfare Program for over three decades, levels of IFA intake during pregnancy remain low. Material and methods: A descriptive study was conducted among 132 postnatal women registered in Anumanthai primary health center (PHC), Villupuram, Tamil Nadu, catering to a population of 56,142 through eight subcenters to explore factors affecting compliance to IFA. One hundred thirty-two postnatal women were interviewed after taking informed consent in local language using a pretested structured proforma. Statistical analysis was done using SPSS Version 16. Results: Majority of the study subjects (134; 98%) were in the age group of 20-29 years. First-trimester registration was 99.4% and 99.3% received at least three antenatal visits at the PHC. Fifty-four (40%) of the study subjects did not consume any IFA tablet at all. Only 31.1% of the study subjects were aware that IFA tablets should be consumed for 100 days. About 25.9% consumed at least above 90 IFA tablets and only 5.9% consumed more than 100 IFA tablets. Nausea and vomiting 85 (63%) and counseling by village health nurse 115 (89%) were reported to be the most common hindering and facilitating factors, respectively. Conclusion: Despite high rates of antenatal visits, the intake of IFA was low.

Use of Insecticide-Treated Bednets in an Urban Coastal Area of Puducherry, India: A Cross-sectional Study.

Use of Insecticide-Treated Bednets (ITNs) has been shown to reduce the incidence of mosquito-borne diseases. However, the impact of ITNs depends on its community acceptance. We studied the ITN usage and factors infl uencing it, following the distribution of one ITN to each family in an urban area of Puducherry. Around 93.6% of the 157 respondents surveyed were aware of mosquito-borne diseases. Coils and vaporizers were used in 91.1% of the families. Around two-fi fths (41.3%) of the 116 families who received the ITNs used it regularly with another 5.1% using it irregularly. Majority of the users (85%) reported reduced mosquito bites and pleasant sleep after use. Small size of ITNs was the most common reason for non-use (46.3%). Families not using normal bed nets at the time of distribution of ITNs were unlikely to use ITNs at present (odds ratio = 5.22, P < 0.001). Therefore, ITN size should be increased and distribution in urban settings should accompany behavior change communication.

Assessment of village water and sanitation committee in a district of Tamil Nadu, India.

A descriptive study was conducted among 75 members of five Village Water and Sanitation Committees (VWSCs) and 15 local residents in Tamil Nadu, India to assess committee's formation and decision making process. There were 64% females and rest were males, all aged between 20 years and 45 years. A total of 50.7% of them passed 12 th standard and 29.3% belonged to self-help groups. Although, all of them were aware about presence of guidelines, none of them knew its contents. About 20% opined that meetings were not being conducted regularly. All members said that they had problems in attending meeting regularly, take decisions if at least 10 (67%) members are present and fund was not adequate for 1 year period. One-third of local residents did not know the committee formation process and none of them aware about guidelines. Formation and decision making process of VWSC should be improved to tackle the sanitation problem.

Determinants of low birth weight: A case control study in a district hospital in Karnataka.

A Case-control study was conducted in District Lady Goschen hospital, Dakshina Kannada district, Southern Karnataka. Subjects were mothers who underwent normal delivery and their neonates. A total of 150 cases and 300 controls were selected. Significant risk factors identified in univariate analysis included pre pregnancy maternal weight (<45 kgs)(OR=6.77), anaemia in pregnancy (Hb<11gm%) (OR=3.11), age less than 20 years (OR=2.96) and maternal height (<145 cms) (OR=2.79). Multiple logistic regression analysis revealed that pre pregnancy maternal weight (<45 kgs)(OR=7.02), anemia in pregnancy (OR=4.37) and maternal age less than 20 years (OR=3.96) were the significant risk factors of low birth weight of term babies. The strategy needs to focus attention on nutrition education to facilitate better weight gain during adolescent period. Discouraging teenage pregnancy is also essential in order to reduce the burden of LBW babies.

Prevalence of overweight and obesity among preschool children in semi urban South India.

This study was conducted to ascertain the prevalence of overweight and obesity in 425 pre-school children (2 to 5 years) using the new Child Growth Standards released by the World Health Organization. Overweight and obesity were defined as body mass index (BMI) > 85th and 95th percentiles for that age and sex, respectively. The prevalence of overweight and obesity was 4.5% and 1.4%, respectively.