Health Education Program on Leptospirosis among College Students in Chennai, South India.

Aim: To determine the level of knowledge on leptospirosis among college students in Chennai, India before and after the health education program. Study Design: Interventional study Place and Duration of the Study: Seven Arts and Science colleges in Chennai, India between January and June 2014. Methodology: After getting prior permission from the Principals of the colleges, the students who were willing to take part in the study were requested to fill serially numbered and labeled semistructured questionnaire (A&B). Questionnaire included demographics and questions on awareness of leptospirosis, risk factors, mode of transmission, symptoms and human vaccine. Questionnaire A was filled (anonymously) and collected after which the education on leptospirosis was provided as a power point presentation. At the end of the program, students filled questionnaire B and submitted. Statistical analysis was done using McNemar test. Results: Out of 501 students, 28% were males and 72% were females. Age of the students ranged from 16 to 37 years with mean of 20.46 years, SD 3.477. Seventy five percent were Hindus, 20% were Christians and 5% were Muslims. Only 36% of the students were aware that Leptospirosis was common in Chennai while after the program 84% were aware of leptospirosis (P< .001). Knowledge on the risk factors of leptospirosis increased significantly after the program (P < .001). Pre awareness assessment revealed poor knowledge on the modes of transmission of leptospirosis and on symptoms of the disease such as fever and jaundice which increased significantly after the intervention (P < .001). Knowledge on human vaccine was found to be less in the initial survey which improved significantly after the awareness program (P < .001). Conclusions: There was significant increase in the knowledge on leptospirosis among the students after the health education program. Such programs are needed to be carried out for a wider dissemination of information.

Reliability and validity of a modified phq-9 item inventory (Phq-12) as a screening instrument for assessing depression in Asian Indians (Cures - 65).

Objectives: To evaluate the validity and reliability of the modified Patient Health Questionnaire(PHQ) 12 item instrument as a screening tool for assessing depression compared to the PHQ -9 in a representative south Indian urban population. Methods: The Chennai Urban Rural Epidemiology Study [CURES] is a large cross-sectional study conducted in Chennai, South India. In Phase 1 of CURES(urban component), 26,001 individuals aged ≥ 20 years individuals were selected by a systematic sampling technique of whom one hundred subjects were randomly selected, using computergenerated numbers, for this validation study. Two self-reported questionnaires (modified PHQ-12 item and PHQ-9 item) were administered to the subjects to compare their effectiveness in detecting depression. Reliability and validity were assessed and Receiver Operating Characteristic (ROC) curves were plotted. Pearson’s correlation was used to compare the two questionnaires. Results: The mean age of the study was 38.6±11.6 years and 48% were males. Pearson’s correlation coefficient between the modified PHQ-12 and the PHQ-9 item was 0.913 [p<0.0001]. Factor Analysis revealed that the modified PHQ-12 item scale can be used as a unidimensional scale and had excellent internal consistency(Cronbach’s alpha:0.88). A cut point of >4 calculated using the ROC curves for the modified PHQ-12 item had the highest sensitivity (92.0%) and specificity (90.7%) using PHQ-9 as the gold standard. The positive predictive value was 76.7%, and the negative predictive value, 97.1% and the area under the ROC curve, 0.979 (95% Confidence Interval: 0.929 - 0.997, p<0.0001). Conclusion: The modified PHQ-12 item is a valid and reliable instrument for large scale population based screening of depression in Asian Indians and a cut point score of greater than 4 gave the highest sensitivity and specificity. ©

Dietary salt intake and hypertension in an urban south Indian population--[CURES - 53].

OBJECTIVE: The aim of the study was to determine the mean dietary salt intake in urban south India and to look at its association with hypertension. METHODS: The Chennai Urban Rural Epidemiology Study (CURES) is an ongoing population based study on a representative population of Chennai city in southern India. Phase 1 of CURES recruited 26,001 individuals aged > or = 20 years, of whom every tenth subject (n = 2600) was invited to participate in Phase 3 for detailed dietary studies and 2220 subjects participated in the present study (response rate: 84.5%). Participants with self-reported history of hypertension, diabetes or heart disease were excluded from the study (n = 318) and thus the final study numbers were 1902 subjects. Dietary salt, energy, macronutrients and micronutrients intake were measured using a validated semi-quantitative food frequency questionnaire. Diagnosis of hypertension was based on the National Cholesterol Education Programme (NCEP) Adult Treatment Panel III criteria. Logistic regression analysis was used to look at the association of dietary salt with hypertension. RESULTS: Mean dietary salt intake (8.5 g/d) in the population was higher than the recommended by the World Health Organization (< 5g/d). Higher salt intake was associated with older age and higher income (p for trend < 0.0001). Subjects in the highest quintile of salt intake had significantly higher prevalence of hypertension than did those in the lowest quintile (48.4 vs 16.6%, p < 0.0001). Both systolic and diastolic blood pressure significantly increased with increase in quintiles of total dietary salt both among hypertensive and normotensive subjects (p for trend p < 0.0001). Addition of salt > 1 teaspoon/day at the dining table was associated with a higher prevalence for hypertension compared to zero added salt (38.5% vs 23.3%, Chi-square = 18.95; p < 0.0001). Multiple logistic regression analysis revealed that even after adjusting for age, gender, body mass index, total energy intake and dietary fat, total dietary salt intake was positively associated with hypertension. [Odds ratio (OR): 1.161, 95% Confidence Interval (CI): 1.115-1.209, p < 0.0001]. CONCLUSION: Intake of dietary salt in urban south India is higher than currently recommended. Increasing salt intake is associated with increased risk for hypertension even after adjusting for potential confounders. This calls for urgent steps to decrease salt consumption of the population at high risk.