Prevalence and Risk Factors of Vitamin A Deficiency in Children and Women of Childbearing Age in a Southern Indian Tribal Population: A Cross-Sectional Study.

BACKGROUND: Night blindness and keratomalacia continue to be a problem among the tribal children and pregnant women residing in Jawadhi hills. OBJECTIVES: The objective of the study is to determine the prevalence and risk factors of Vitamin A deficiency (VAD) among children aged 1-8 years and women of reproductive age in a southern Indian tribal population. MATERIALS AND METHODS: A cross-sectional study was done among children aged 1-8 years and women aged 15-45 years residing in Jawadhi hills. Participants were randomly selected by cluster sampling. Their sociodemographic characteristics and frequency of consumption of Vitamin A rich food were collected through a structured questionnaire. Anthropometric measures and serum retinol levels, using high-performance liquid chromatography, were estimated for all participants. RESULTS: A total of 166 children and 211 women participated in this study. The prevalence of VAD among the children (1-8 years) was 10.2% (95% confidence interval [CI] 5.5%-14.9%) and among women of the reproductive age group was 3.8% (95% CI: 1.2%-6.4%). Dietary intake was not associated with serum retinol levels. Low educational status of the head of the household (adjusted odds ratio [aOR] = 8.9) and pregnancy (aOR = 11.6) was significantly associated with an increased risk of VAD among children and women, respectively. CONCLUSIONS: The prevalence of VAD among children is a moderate public health problem. Strategies must focus on pregnant women and children from families with more than four children.

Prevalence and Factors Associated with Gestational Diabetes Mellitus among Antenatal Women at a Rural Health Center in Vellore.

BACKGROUND AND OBJECTIVES: Gestational Diabetes Mellitus (GDM) has been well documented to be associated with significant mortality and morbidity among both mother and their offspring. Prevalence of GDM in India varies between regions and has been documented to be on the rise over the last two decades which is a public health concern and reflects an increase in the frequency of type 2 diabetes mellitus in these populations. This study aimed at estimating the prevalence of GDM among antenatal women attending a rural secondary care hospital in southern India and attempts to study associations between anthropometry, parental history, physical activity of pregnant women and GDM. METHODS: A hospital based cross sectional study was done among 630 pregnant women who were screened with oral glucose tolerance test between 24 and 28 weeks of gestation based on IADPSG criteria. Risk factors for developing GDM were assessed by conducting home visits to 75 women diagnosed to have GDM and 150 randomly selected women without GDM. RESULTS: Hospital based prevalence of GDM was 14% (95 % CI: 11.3% to 16.7%) and a significant rise in prevalence levels was noted with age. Women with family history of diabetes mellitus, women with body fat of more than 23% had 2.65 and 2.89 times significantly higher odds of developing GDM. Interpretation and conclusion: Family history of diabetes and excess body fat are risk factors associated with GDM. Among them excess body fat could be an independent risk factor without the influence of foetal weight and preventive measures could be directed towards it.

Sero-prevalence of rubella among pregnant women in India, 2017.

BACKGROUND: We conducted a sero-survey among pregnant women attending antenatal clinics of six hospitals which also function as sentinel sites for CRS surveillance, to estimate the prevalence of IgG antibodies against rubella. METHODS: We systematically sampled 1800 pregnant women attending antenatal clinics and tested their sera for IgG antibodies against rubella. We classified sera as seropositive (titre ≥10 IU/ml), sero-negative (titre <8 IU/ml) or indeterminate (titre 8-9.9 IU/ml) per manufacturer's instructions. In a sub-sample, we estimated the titers of IgG antibodies against rubella. IgG titer of ≥10 IU/mL was considered protective. RESULTS: Of 1800 sera tested, 1502 (83.4%) were seropositive and 24 (1.3%) were indeterminate and 274 (15.2%) were sero-negative. Rubella sero-positivity did not differ by age group, educational status or place of residence. Three hundred and eighty three (87.8%) of the 436 sera had IgG concentrations ≥10 IU/mL. CONCLUSION: The results of the serosurvey indicate high levels of rubella sero-positivity in pregnant women. High sero-prevalence in the absence of routine childhood immunization indicates continued transmission of rubella virus in cities where sentinel sites are located.

Compliance to treatment among type 2 diabetics receiving care at peripheral mobile clinics in a rural block of Vellore District, Southern India.

BACKGROUND: Providing treatment to patients with diabetes mellitus in rural areas at a cost they can afford is a public health challenge. AIMS: This study aims to measure the rate of compliance to oral hypoglycemic agents among patients with type 2 diabetes mellitus attending peripheral mobile clinics in rural South India. To study factors that impact glycemic control. SETTING AND DESIGN: A cross-sectional study was done among patients attending peripheral mobile clinics in a rural block in Southern India. MATERIALS AND METHODS: Pill counts were done to assess compliance. Participants' dietary intake was measured using a 24 h diet recall and their level of physical activity was measured using the WHO Global Physical Activity Questionnaire. Glycated hemoglobin (HbA1c) was measured for all participants. STATISTICAL ANALYSES USED: Data were entered on EpiData and analyzed using SPSS. The prevalence of good glycemic control and good compliance was measured. A multiple linear regression was done to study factors affecting glycemic control. RESULTS: Overall 52% of the participants were compliant to at least one drug and 50% had achieved good glycemic control. Compliance increased by 2.1% with every passing year since the diagnosis of diabetes. HbA1c reduced by 0.09% for every 10% increase in overall compliance. CONCLUSIONS: Levels of compliance and glycemic control achieved through this primary care team is comparable to those achieved through other systems.