Reproducibility and validity of a quantitative food frequency questionnaire in an urban and rural area of northern India.

Background. Food frequency questionnaires (FFQs) have been used in epidemiological studies across the world to capture the usual food intake of individuals. As food habits vary in different population groups, FFQs should be validated before use. Hence, we determined the reproducibility and validity of FFQs designed for urban and rural populations of northern India. Methods. Separate FFQs, designed for urban and rural populations using standard methods, were administered to a sample of 200 subjects (100 urban and 100 rural) in the age group of 35–70 years in the beginning (baseline FFQ) of the study and after an interval of 1 year (1-year FFQ) to assess their reproducibility. Six 24-hour dietary-recalls, taken at an interval of 2 months over a period of 1 year, were used as a reference method to test the validity. Crude and energyadjusted nutrient intakes estimated from FFQs and 24-hour dietary-recalls were compared using Pearson correlation coefficients. Bland and Altman plots were also used to test the agreement between the two methods. Results. Nutrient intakes were found to be similar at the baseline and 1-year FFQs in urban and rural areas. The unadjusted Pearson correlation between 24-hour dietaryrecalls and 1-year FFQ ranged from 0.22 for vitamin C to 0.63 for iron in the urban area. It ranged from 0.06 for vitamin C to 0.74 for energy in the rural area. The correlations lowered after adjusting for energy and there was a minimal increase after de-attenuation. Conclusion. The FFQs were reproducible and valid for assessing nutrient intakes except for some micronutrients.

Tracking progress towards sustainable elimination of iodine deficiency disorders in Orissa.

OBJECTIVE: To assess the status of iodine deficiency in the population of Orissa and track progress of the elimination efforts. METHODS: A community based field survey was conducted. Data was collected using quantitative and qualitative research methods. Standard internationally recommended protocol and methodology was followed. Thirty clusters were selected using population proportionate to size sampling technique. School children aged 6 to 12 years were selected as target group. Goiter prevalence, urinary iodine excretion in the target group and iodine content of the salt at household were used as outcome variables. RESULTS: A total of 1200 children were studied. The total goiter rate was found to be 8.0%, of which 7.6% were grade I and 0.4% was grade-II goiter. The median urinary iodine excretion was found to be 85.4 microg/L and 32.2% of the subjects had urinary iodine levels less than 50 microg/L. Estimation of iodine content by titration method revealed that in only 45% of households salt was found to be adequately iodised. (Salt with iodine level 15 ppm). CONCLUSION: Iodine deficiency continues to be a public health problem in Orissa and the need to accelerate efforts to iodine sufficiency cannot be overemphasized.

Review of screening and preventive strategies for cervical cancer in India.

Cervical cancer is the commonest cancer among Indian women. The predominant risk factor is persistent infection with human papilloma virus (HPV) which is now well established. Despite being the commonest cancer, and the fact that it is a type of cancer, which can be detected early by sensitive screening methods there is no effective screening programme or preventive strategy for reducing its burden. This article reviewed the published studies that has been carried out in India during 1965-2005 on cervical cancer with emphasis on screening by Pap smear and other alternative methods. Conventionally, Pap smear cytology is the only method for screening; but recently various studies have been carried out to explore alternative methods like visual inspection methods. Due to the operational difficulties by Pap smear, these alternative screening methods could be more feasible for organized population based screening in a low resource country. There is therefore a need for initiating screening programmes within the existing health system in India.

Current status of communicable and non-communicable diseases in India.

India is going through a period of transition, both epidemiological and demographic transition. Infectious diseases are still persisting as major health problems in spite of having national programmes for the control of most of these diseases for almost half a century now. This paper focuses on two national programmes: the success story of the National Leprosy Eradication Programme; and the National Anti-Malaria Programme that has failed to achieve its objectives. There are re-emerging infectious diseases which are adding to the burden of diseases. In addition, there is an increasing prevalence of non-communicable diseases as a result of lifestyle changes and urbanization. These are the challenges that are to be tackled in the new millennium.