Strengthening opportunistic screening for hypertension: report from a tertiary care institution in a district of West Bengal, India

Background: Hypertension is a major public health problem in India and considered as a silent killer disease. The national program for prevention and control of cancer, diabetes, CVD and stroke (NPCDCS) recommended opportunistic screening for hypertension at all levels health facility. The present study was conducted with the objectives to estimate the magnitude of hypertension among the General OPD attendees aged 18 years and above in tertiary care hospital in a district of West Bengal and to find out the factors influencing hypertension among them.Methods: The study was a hospital based observational, descriptive study with cross sectional design and conducted among 244 study participants in 2018. Study variables included socio demographic factors and both modifiable and non-modifiable risk factors for hypertension.Results: In this study 40.2% subjects had normal blood pressure, 18.4% were known hypertensive and 101 (41.3%) people were newly diagnosed as having high blood pressure. Among known hypertensive, 75% had poor control of hypertension. Age, religion, family history of hypertension, body mass index (BMI) and central obesity had significant association with hypertension.Conclusions: The study recommended strengthening of opportunistic screening of all patients for hypertension at all levels of health care, especially through the village health nutrition day platform and providing treatment free of cost. Awareness generation and counselling for lifestyle modification should also be strengthened.

Taking stocks of antimalarial activities: A study on knowledge and skill of health personnel at primary care setting in the state of West Bengal, India.

Background: Early diagnosis and effective treatment are the key areas in malaria control in India. Objective: The present study was carried out to assess the knowledge and skill of health personnel at primary care level and the logistic support related to the program at subcenter (SC) level. Methods: A cross-sectional, descriptive study was conducted among medical and paramedical personnel working at primary health-care institutions in two districts of West Bengal. Knowledge was assessed using a structured questionnaire while diagnostic skill and logistic support were assessed with structured checklists. Clinical skill was assessed with case vignettes. Results: Requisite knowledge on diagnostic procedure was found in two-third to three-fourth of health personnel while only 26.7% and 12.4%, respectively, knew the correct treatment of Plasmodium vivax and Plasmodium falciparum malaria. Median standardized score for knowledge was 50.0 while the scores for skill of preparing blood slide and for rapid diagnostic test were 70.0 and 57.1, respectively. Education and work experience were related to diagnostic skill but had little effect on knowledge. In clinical skill, medical personnel scored 50% or more in investigation and treatment aspects only. In another case vignette, health workers excelled over medical officers and other staff in all axes other than history taking and clinical examination although their performance was also suboptimal. Formal training on malaria did not show any bearing on median knowledge and skill score. Supply of diagnostics and drugs was insufficient in majority of SCs. Conclusion: Renewed efforts are needed to create competent workforce and ensure adequate logistic supply.

A study on utilization of Janani Suraksha Yojana and its association with institutional delivery in the state of West Bengal, India.

Background: India launched the Janani Suraksha Yojana (JSY) on the principles of conditional cash transfer providing monetary incentive to needy women to improve access to institutional childbirth. Objectives: This study was conducted among JSY-eligible women who delivered between April 2012 and June 2012 to assess the utilization of cash incentives toward institutional delivery, along with other associated factors influencing institutional delivery. Methods: It was a cross-sectional, descriptive study conducted between July 2012 and May 2013 on 946 women selected through stratified random sampling of subcentres from better and worse performing districts of West Bengal. Results: 74.7% of the study population was JSY-eligible. 90.2% of those who took three antenatal check-ups (ANCs) and 36.8% JSY-noneligible women received cash. Government institutions were preferred for childbirth among all groups irrespective of JSY eligibility, receipt of cash, and number of antenatal visits. Overall, 78.8% opted for institutional delivery if they had received cash, which was significantly more than those who did not (64.5%). JSY-eligible women were 1.5 times more likely to deliver in government institutions compared to JSY-noneligible women. With no incentive, the likelihood of institutional delivery was halved. The distance of a 24 Χ 7 delivery hub beyond 5 km (74.8% vs. 81.8%), the religion of Islam (62.7% vs. 83.2%), and multiparity (63.9% vs. 83.6%) were significant deterring factors. Conclusion: Despite some inclusion and exclusion errors, cash incentive under JSY was associated with increased institutional delivery, especially in government institutions though there were other factors influencing the decision as well.

Domestic violence among ever married women of reproductive age group in a slum area of Kolkata.

Background: Domestic violence has serious impact on women's health and well-being. A nationwide survey conducted in India observed that 37.2% of women experienced violence after marriage. Objectives: To assess the prevalence of domestic violence among the ever married women in reproductive age group and to find out the types of domestic violence and factors associated with it. Materials and Methods: The study was a community based cross-sectional study, conducted in a slum area of Kolkata. Results and Conclusion: Overall prevalence of domestic violence was 54%, of which 41.9% suffered from both current and lifetime physical and psychological violence. Presence of property, higher per capita income and social support were protective factors against domestic violence, whereas alcohol addiction and multiple sex partners were the important contributory factors for it. The study recommended more social support, awareness and income generation for women in the slum areas.

A study on the role of parental involvement in control of nutritional anemia among children of free primary schools in a rural area of West Bengal.

An intervention study was conducted among students of three randomly selected free primary schools in rural West Bengal to assess the effect of health-nutrition education for behavior modification of parents on nutritional anemia of children. Clinically anemic students were school-wise randomized into 'groups of two' and intervened with anthelminthic, iron-folic acid (IFA) pediatric tablet and health-nutrition education by reoriented teachers. Parents of study group were involved in behavior change processes. Baseline overall prevalence of anemia was 64.4%. After IFA therapy, prevalence of anemia was not found to differ between two groups (χ2 = 2.68, P > 0.05, RR= 0.48, 95% C.I 0.2 < RR < 1.19) while reducing 52.2% of relative risk. Reassessment after six months showed significantly lower prevalence in study group (χ2 = 18.14, P < 0.05, RR = 0.20, 95% C.I. 0.08 < RR < 0.49). Parental involvement for life style and dietary modification may curb childhood anemia.

Epidemiological study of measles in slum areas of Kolkata.

OBJECTIVE: An epidemiological study on measles was conducted among the under five children in slum areas of Kolkata to assess the incidence of measles. METHODS: 20 cluster sampling technique was followed and in each cluster 250 under five children were covered. Paramedical workers identified children of the target of age group who had history of measles in past one year and the medical officer confirmed the diagnosis following standard case definition. RESULTS: Incidence of measles was found as 5.76%. Incidence was equal in both the sex groups, but found more among infants. The incidence of measles gradually declined with the increase of age strengthening the view in favor of early immunization. Amongst the measles cases only 19.7% were immunized with measles vaccine. 100% of measles cases gave history of rash, 98.9% had history of fever, 82.8% reported that the rash started from face and progressed downwards to abdomen and leg. Cough, redness of eye and discoloration of skin were reported by 97.5%, 83.8% and 65.2% measles cases respectively. Only 16.9% and 8.6% children received Vitamin A oil before and after the illness respectively. 49% gave history of exposure to measles cases and 46.6% cases had measles within 2 weeks incubation period. CONCLUSION: The study highlighted the necessity of timely measles vaccine coverage, additional dose at a higher age and Vitamin A supplementation through IEC activities.

A study on morbidity pattern of child labourers engaged in different occupations in a slum area of Calcutta.

A cross-sectional study of 150 child labourers engaged in different occupations in a slum area of Calcutta was conducted to assess their health and nutritional status. Most (88%) of them had some type of morbidity. Female child workers (95.5%) suffered more than the males (84.7%). Most prevalent morbidities among the child labourers were seen as pallor (49.3%) followed by pediculosis (48%), dental caries (28.6%), malnutrition (22.6%), worm infestation (20.6%) and scabies (16.6%). Garage workers were observed to suffer less from any type of morbidity except pallor which may be attributed to lead exposure. Rag-pickers had significantly (p < 0.05) more risk of developing worm infestation, scabies and pediculosis whereas domestic helpers had significantly (p < 0.05) more risk of developing pediculosis. Occupational hazards were also studied but excepting pallor in garage workers and scabies in rag-pickers, nothing could be documented.