Management of Severe Acute Malnutrition in Day Care Settings : Findings fromInnovative Public Private Partnership at Devbhumi Dwarka District, Gujarat

Introduction :Severe Acute Malnutrition (SAM) is a major public health concern that is linked to a high mortality rate in children under the age of five. Government of Gujarat has expanded treatment network from government facilities to private institutions and non-governmental organizations through various initiative in an effort to address the issue of SAM. To assess the treatment outcome among SAMObjective: children (0-5 years) admitted at Niramay Bal Poshan Kendra, Jam Khambhalia, Devbhumi Dwarka District of Gujarat. A longitudinal study was conducted among SAM children admitted at he Niramay BalMethod: t Poshan Kendra (Public Private Partnership model under Bal Poshan Yojana) which is a day care center providing treatment to SAM children for 14 days according to the protocol of NRC (Nutrition Rehabilitation Centre). Under Bal Poshan Yojana, RBSK medical officers screen children for SAM and refer them for treatment at empanelled NGO/Private institution. Total 1557 under five children were screened by them between 6 September 2021 and 5 February 2022. Out of them 121 SAM children were identified, 95th th children could be mobilized at the study site (Niramay Bal Poshan Kendra). Out of 95 children, 76 SAM children completed the treatment along with all three follow up at the study site. The data of these 76 Children was analyzed. Among 76 children, average weight gain was 566 grams at the time ofResults: discharge and 1000 grams at the time of third follow-up. An average weight gain for the cohort is 5.2 gram/kg/day. At the end of treatment, 92% children moved out of the SAM category at the completion of three follow-up, 55% moved to Moderate Acute Malnutrition and 37% to normal weight category. Conclusion: An average weight gain among the study population was satisfactory. Day care treatment model provides advantage of improved treatment completion rate and higher follow-up com

Prevalence of dental caries in first and second permanent molars.

Background: This study was conducted to assess the First and Second molar permanent molar caries in school children of Nalgonda district, Andhrapradesh, India. Methods: We have taken total 1800 school going children as study population age between 12-15 years, who lived in the same place since birth and consumed drinking water form single source. Results: The mean of caries in first and second were 0.12 ± 0.36 and 0.36 ± 0.70 respectively and total was 0.49 ± 0.92. Conclusion: The prevalence of Second molar teeth was found higher than First molar teeth and these caries were untreated.

Study of socio-demographic factors affecting prevalence of hypertension among bank employees of Surat City.

Cardiovascular diseases including hypertension are increasing in developing countries especially among high-risk group people like bank employees. A cross-sectional study of 1493 bank employees of Surat city was conducted during August, 2004 to September, 2005 to study the prevalence of hypertension among bank employees and the effects of socio-demographic factors on prevalence of hypertension. Data were analyzed using epi 6 software. The χ[2] -test was applied as a nonparametric test of statistical significance. Prevalence of hypertension was 30.4% and prehypertension was 34.5%. Out of 455 found as hypertensive, 258 (56.70%) were not having any symptoms at the time of examination. Prevalence was high among persons with age 50 years and above (48.5%); among male (32.5%) as compared to female (23.1%); among employees having small family size; among separated/divorcee person (40.0%). Prevalence of hypertension increased with seniority of the official position of bank employee with highest prevalence among managers (45.9%). Prevalence of hypertension was noted highest among the higher socioeconomic group; SEC I (35.0%) followed by class II (20.4%). Effects of different risk factors of hypertension were observed here. This study may help in identifying the common profile of hypertensive or persons at risk, which may further help in identifying the risk group and planning the group specific IEC interventions.

Spectrum of visual impairment among urban female school students of Surat.

Aim: Eye morbidities with or without symptoms delineate a significant morbidity among adolescent schoolgirls in India. The study was undertaken to assess the extent of visual impairment and ocular morbidity to identify influencing factors and the impact on scholastic performance. Materials and Methods: A population-based cross-sectional study was undertaken among 3002 urban girl students of Surat in Gujarat, India. Overall prevalence of refractive error was found to be 15.22%; myopia affected 91.47%, hyperopia 4.60%, and astigmatism 0.04%. The prevalence of myopia and astigmatism was more in higher age groups, while hyperopia was more in lower age groups; even students with good vision reported ophthalmic symptoms. Of all spectacle users, in 29.73% cases the eyesight was not found to be with the best possible corrections. Refractive error was observed to be higher among the general caste (50.98%) and among Muslims (54.05%). Still, among those with problems of eyesight, 75.93% students had good academic performance. Associated ocular morbidity was noted in 20.35% participants along with the refractive error. Conclusion: This study highlighted the load of eye morbidities of adolescent Indian urban girls.

Sexually transmitted infections and reproductive tract infections in female sex workers.

The present study was conducted in 300 female sex workers (FSWs) from Surat city in 2005-2006. Vaginal swabs, endocervical swabs and serum samples were collected from each of these FSWs. Vaginal samples were screened for bacterial vaginosis (BV), candidiasis and Trichomonas vaginalis . Endocervical swabs were screened for gonococcal infection. Serological tests for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) and syphilis were performed. From a total of 300 FSWs, BV was detected in 40 (13.33%), trichomoniasis in six (2%), candidiasis in 31 (10.33%), HIV seropositivity in 35 (11.66%), HBsAg reactivity in 10 (3.33%) and rapid plasma regain (RPR) reactivity in 20 (6.66%) cases. RPR-positive serum samples were confirmed by the treponema pallidum hemaglutination test. Gonococcal infection was not found in any of the FSWs. Of the total of 35 HIV-positive patients, 20 patients had associated coinfection. Of the 35 HIV-seropositive FSWs, BV was detected in six (17.14%), candidiasis in six (17.14%), syphilis in five (14.28%) and HBsAg in two (5.71%). One (2.85%) HIV-positive FSW was positive for both candidiasis and syphilis.

A case control study to explore the risk factors for acquisition of leptospirosis in Surat city, after flood.

BACKGROUND: Between August and November 2006, a population-based case control study was conducted to identify the probable risk factors for leptospirosis during flooding in Surat city. MATERIALS AND METHODS: Sixty-two laboratory confirmed cases out of 129 suspected cases, and 253 age and sex matched fever and healthy controls were interviewed with the help of predesigned questionnaire. The association of risk factors with acquiring leptospirosis was assessed by adjusted OR with the help of logistic regression model to control confounders. RESULTS: By univariate analysis, factors identified were, walking barefoot (OR = 10.34, 95% CI 5.09-21.31, P <0.05). CONCLUSIONS :Prompt and vigilant fever surveillance activities in pre-monsoon preparedness plan, intensive IEC messages, rodent control programs and improvement of environmental sanitary conditions may help to greatly reduce the incidence of leptospirosis.

Domestic environment and morbidity of under five children.

Healthy environment for children initiating an alliance for action (WHO) has reported that over 40% of the global burden of disease attributed to environmental risk factors fall on children below 5 years of age, who account for about 10% of the world's population. That is why to look into the new area of concern, this cross sectional study was carried out to explore the influence of domestic environment over the illness of under five children.

Prevalence of Trichomonas vaginalis infection in and around Surat.

Trichomonas culture method was used for the diagnosis of trichomoniasis along with gram staining and wet mount preparation. We selected 51 urban women and 51 rural women in this study. Samples were taken from both symptomatic and asymptomatic individuals. Out of 102 samples 35 samples were positive for Trichomonas vaginalis by culture method. 20 women were positive for Trichomonas vaginalis by wet mount and 15 by gram staining technique. So it is a fact that culture of Trichomonas vaginalis is a "gold standard" in the diagnosis of trichomoniasis. As we had the opportunity to compare both urban and rural women in our study we were able to come to the conclusion that incidence of Trichomonas vaginalis is more in urban women than in rural women.

Effect of physical and mental activity on blood pressure.

OBJECTIVES: The authors measured and recorded the physical (outdoor playing) and mental (home study) activity behavior and blood pressure amongst school going children and observed their association with the blood pressure levels. METHOD: It was a cross sectional school-based study from 12 primary schools; selected by stratified random sampling. Participants included 2250 children aged 10 years and above. Explanatory variables were age, sex, outdoor playing (hours/ day) and home-study (hours/ day). Outcome variables were mean and standard deviation (SD) of systolic and diastolic blood pressures in various activity groups. Statistical tools used were proportions, correlation co-efficient (r), coefficient of determination (r2) and Regression analysis. RESULTS: 47.8% boys and 2.5 % girls were engaged in outdoor playing for more than two hours. No trend was observed for systolic blood pressure (SBP) in both the sexes in various activity groups of outdoor playing. Both mean diagnostic blood pressure (DBP) and mean BMI showed decreasing trend in boys. Mean BMI had an inverse relationship with outdoor playing in girls. Correlation of age and weight with both SBP and DBP was highly significant in both the sexes and in all the age groups except that of the 15-year age. Both SBP and DBP were not associated with home study in all sex and age groups except the age group of 10 and 12 years. Both SBP and DBP were significantly associated with the outdoor playing taking the whole sample as one group, but not in different sex or age groups; except that the SBP was significantly correlated with outdoor playing in 10 to 13 years age groups in boys. CONCLUSION: Boys spent twice the time in outdoor playing than girls. They were spending more time on outdoor playing than on home study. Conversely girls spent more time in home study. A weak negative correlation was observed between outdoor playing and blood pressures. Less time spent in physical activities by the girls may have contributed to their higher BMI. They need behavior change communication for involvement in physical activities.

Impact assessment of mass measles vaccination.

OBJECTIVE: The mass measles vaccination campaign was conducted in the slums of Surat City, in Gujarat State, as a part of urban measles control initiative in India. One dose each of the vaccine was administered to children in the age range of 9-59 months residing in these slums, regardless of their previous vaccination status. METHODS: One year later, (October 2000), the present study was carried out in order to assess the impact of the mass vaccination campaign on the vaccination coverage and on the incidence of measles by comparing the findings with those of the baseline survey carried out in May 98. This was a retrospective study with a recall period of the preceding year. 3,147 children under five were studied in thirty slum clusters selected by the cluster sampling method. The parents/caretakers of these children were interviewed for information on any episode of fever with rash conforming to the case definition. RESULT: The incidence rate for measles declined from 7.7 percent reported in the baseline (May 1998) to 3.5 percent in the impact assessment study. The incidence was 8 times higher in unvaccinated children. The mean and median age at contracting the illness increased from 26 +/- 14.2 months and 26 months in the baseline to 30.9 +/- 14.7 months and 30 months respectively in the impact assessment. The vaccination coverage had improved from 48.3 percent to 73.7 percent following the campaign. CONCLUSION: The compaign increased vaccination coverage decreased disease incidence and caused a shift towards higher age-groups in vaccinated children.