Assistive technology usage, unmet needs and barriers to access: a sub-population-based study in India.

Background: Assistive technology (AT) is essential to minimize functional limitations. The current study aimed to estimate the prevalence of needs, met and unmet needs for AT, and barriers to accessing AT among a subnational population in India. Methods: This cross-sectional study was conducted in eight districts, representing four zones of India, using the WHO Rapid Assistive Technology Assessment (rATA) tool. The tool was administered by trained staff using read aloud technique. Multi-stage cluster random sampling was used, as well as the probability proportional to size, to select smaller administrative units from the larger ones. Findings: In total, 8486 participants were surveyed out of 8964 individuals enumerated with a response rate of 94.6%. The sample prevalence of at least one difficulty was 31.8% (2700), with 6.3% (532) having severe or total difficulties. The sample prevalence for AT need was 27.8% (2357) with an estimated population prevalence of 24.5% (95% CI: 23.5-25.4). Similarly, the sample prevalence of unmet needs was 9.7% (823) with an estimated population unmet needs of 8.0% (95% CI: 7.43-8.60). The unmet needs among persons with severe or total difficulties was 52.3% (278/532), and was higher among females, rural residents, and older persons. Spectacles were the most used products, followed by canes/sticks, tripods, and quadripods. Nearly two-thirds of AT users purchased assistive products at their own expense, particularly from the private sector. The inability to afford AT (36.9%) was the most common barrier. Interpretation: The results show that the need for AT was substantial in the study population, the highest being for seeing difficulties. The unmet needs are higher in females, older population, rural residents, and persons having serious difficulties. While the majority of users have to make out-of-pocket payments to obtain AT, inability to afford and limited availability were the common barriers among those with unmet needs. Funding: This research is non-commercial, and was conducted in the interest of public health. The authors have not declared any specific grant for this research.

Dermatological Symptoms among Polyester Dyeing and Printing Workers in Mumbai.

Background: Textile is one of the important sectors in the Indian economy. The use of synthetic chemicals is maximum during the wet processing technique, which consists of dyeing, printing and finishing. Aims and Objectives: This study was conducted to find out the prevalence of occupational dermatological symptoms among the workers employed in the dyeing and printing unit of the textile industry. Materials and Methods: A cross-sectional study, with a sample of 242 workers, was conducted in three different dyeing and printing factories. The workers were interviewed using a semi-structured questionnaire adapted from the Nordic Occupational Skin Questionnaire. Results: The prevalence of dermatological symptoms on the hands was found to be 51.7%. The various pattern of lesions included redness in 0.4% to itching in 26% of dyeing and printing workers. Those working for >5 years had 2.21 times higher risk as compared to those working for ≤5 years Odds Ratio (OR): 2.21; 95% Confidence Interval (CI): 1.19-4.11). Similarly, those working in the dyeing section were at 2.94 times higher risk as compared to those working in the printing section (OR: 2.94; 95% CI: 1.58-5.47). Conclusion: The workers working in the printing and dyeing industry were at risk of developing skin lesions, which can partly be attributed to reactive chemicals used and partly to poor handling practices of the workers.

Assessment of health status and impact of pollution from thermal power plant on health of population and environment around the plant in Udupi District, Karnataka.

Background: Coal-fired thermal power plants (TPPs) have a serious impact on soil, air, and water quality resulting in deterioration of health and environment around the plant. Objective: The present study was undertaken with the objectives of assessing the respiratory health status of the population around the plant and to measure selected heavy metals in fly ash, air, water, and soil samples. Materials and Methods: The current cross-sectional study was conducted among 3533 adult residents living in two strata within 10 km radius around the TPP in Udupi district of Karnataka state. Data were collected by using semi-structured questionnaire and spirometry and environmental air monitoring by DustTrak aerosol monitor, water, and soil samples were collected for analysis. Results: Majority of the study participants were in the age group of >45 years (41.4%). 70.6% were females and 0.39% were trans-genders. 4.3% were suffering from various respiratory problems. Bivariable logistic regression showed subjects aged 46-65 years and >65 years have 2.91 times and 4.42 times higher odds of respiratory disease as compared to those with age ≤45 years. Multivariable logistic regression showed significant association between higher age group (P < 0.0001) and in subjects who had closed window during cooking (P < 0.006). Levels of heavy metals in soil samples and particulate matter 2.5 were well within permissible limits whereas the ground water samples had excess levels of iron, manganese, and copper. Conclusion: The present study has implications for policymaking to protect the environment and health of vulnerable populations in industrial clusters and the vicinity of power plants.

Assessment of knowledge, attitude, and practices regarding biomedical waste management among operation room personnel in a tertiary care center.

BACKGROUND AND AIMS: Biomedical waste management is an important issue of concern to all healthcare personnel as inappropriate management has the potential for serious infections and noninfectious injury to patients and care providers. Operation room is a department in the hospital wherein large amounts of waste are generated on a daily basis. This study aims to evaluate the knowledge, attitude, and practice regarding biomedical waste among operation room personnel. MATERIAL AND METHODS: This is a cross-sectional study done among various strata of operation room personnel with a questionnaire to evaluate the knowledge, attitude, and practice with respect to biomedical waste management. RESULTS: This study revealed gaps in knowledge and practices among all strata of operation room personnel regarding biomedical waste management. CONCLUSION: This study highlights the need for appropriate training of all operation room personnel about appropriate waste management practices.

Building global partnerships through shared curricula for an MPH programme in India and Sri Lanka.

OBJECTIVE: To design and implement a locally relevant competency- based MPH programme. METHODS: The demand for trained public health professionals in South Asia is enormous and growing, which created a unique opportunity for a Fogarty International Center-funded University of Alabama at Birmingham-South Asia [Aga Khan University, Pakistan; Manipal Academy of Higher Education, India; and University of Kelaniya, Sri Lanka] international research training in environmental and occupational health (ITREOH) programme. In 2009, a Master of Public Health (MPH) degree programme was designed using a combination of competencies developed by the Association of School of Public Health, the World Health Organization and the Centers for Disease Control and Prevention. RESULTS: A competency- based curriculum was developed with two specialty tracks in applied epidemiology and environmental and occupational health, emphasising applied practice and research. CONCLUSIONS: This is the most comprehensive skill-based MPH programme in the region, which positions each institution as a regional leader in public health training. The success of the programme has been amply demonstrated by placements of graduated MPH students in leadership roles in public, private and academic sectors within their countries.

Effect of muscle energy technique with and without strain-counterstrain technique in acute low back pain - A randomized clinical trial.

BACKGROUND: Muscle energy technique (MET) and strain-counterstrain (SCS) technique are found to be effective as a sole treatment of acute low back pain (LBP), but the combined effect of these two techniques has not been evaluated. OBJECTIVE: The purpose of this randomized clinical trial was to evaluate the added effect of SCS to MET in acute LBP patients. METHODS: In this trial, 50 patients were randomly allocated to MET or MET-SCS group to receive the assigned two treatment sessions for two consecutive days. Oswestry disability index (ODI) and Roland Morris disability questionnaire (RMDQ), visual analogue scale (VAS), lumbar range of motion (ROM) were recorded at baseline, after first and second session. RESULTS: All the outcome measures showed statistically significant ( p < 0.05 ) improvement in both the groups after second session. Between the groups, analysis showed no statistically significant difference ( p > 0.05 ) after the first or second session. CONCLUSIONS: The improvement after second treatment sessions was noted in pain, ROM, and disability in both the groups, but immediate effect was seen only on pain intensity after first treatment session. When compared between the groups, no added effect of SCS to MET was found in reducing pain and disability and increasing lumbar ROM in acute LBP patients.

Occupational Health and Role of Gender: A Study in Informal Sector Fisheries of Udupi, India.

BACKGROUND: Fisherwomen are informal sector workers involved in post-harvest operations and are mostly engaged in peeling, trading, and processing of fish. High degree of wage disparity and gender inequalities results in different socioeconomic status of fisherwomen and fishermen. This study aimed to identify gender issues and their effect on the health status of fisherwomen. MATERIALS AND METHODS: The present cross-sectional included 171 fishermen and fisherwomen. Interview technique was used to collect information using a predesigned proforma. Data was analyzed using SPSS Version 15.0. RESULTS: Fifty-five percent of the participants complained of work-related health problems. A total of 63.9% of women had occupational health problems compared to 48.5% of the men (P < 0.05). Merely 1.2% of participants used any protective equipment. None of the workers reported receiving any kind of benefits at their workplace. A total of 53.8% were paid on piece-rate basis. CONCLUSION: This study identified many occupational and gender issues in the informal sector.

Psychological impact on caregivers of HIV-infected children in Udupi district, Karnataka.

Caregivers of children living with HIV/AIDS (CLWHA) face unique challenges due to disease-related stigma and discrimination, isolation from society, financial constraints, grief and mortality of loved one. A descriptive cross-sectional study was conducted at Udupi ART centre to assess the caregiver burden, psychological distress and their associated factors among the caregivers of CLWHA in Udupi District. The convenience sampling technique was used to collect the data from 171 caregivers and analysed with the help of SPSS version 15.0. Majority of caregivers were female (64.9%) with mean age of 38.1 ± 9.6 years. About 64.3% caregivers were HIV-positive and 63.2% were biological parents of CLWHA. Mild-to-severe caregiver burden on Zarit Burden Inventory (ZBI) was reported among 84.8% of caregivers, and mild-to-severe psychological distress on General Health Questionnaire (GHQ-12) was reported among 49.7% caregivers. Relationship with child was found to be a significant predictor of caregiver burden as compared to other relatives/foster (P < 0.001). Relationship with child (P 0.004), Alcohol use (P 0.008) and Schooling of children (P 0.049) were reported as significant predictors of psychological distress. Study concludes that caregiver burden and psychological distress were high among caregivers of CLWHA. Psychological problems of caregivers need to be addressed and integrated along with the clinical care of HIV-infected children at ART centres.

Postpartum related morbidities among women visiting government health facilities in Udupi Taluk, Karnataka, India.

BACKGROUND: Maternal morbidities are considered a leading contributor to the burden of disease among women. Especially, if postpartum morbidities are left untreated, this can cause a negative impact on the quality of life. The study was conducted to determine the proportion and types of postpartum morbidities among women visiting government health facilities in Udupi Taluk, Karnataka and to find out the association between the morbidities and various factors. SUBJECTS AND METHODS: A cross-sectional study was conducted in various government hospitals in Udupi Taluk, consisted of 229 postpartum women. These subjects were selected from mothers who accompanied their children for immunization from February 2013 to July 2013 using purposive sampling technique. Multiple logistic regression analysis was used to find out the association between the morbidities and various factors using SPSS version 15. RESULTS: Among 112 (48.9%) women who experienced postpartum morbidities, back pain (23.6%), and perineal pain (15.7%) were most commonly reported physical morbidities. Similarly, anxiety (10%) and irritability (7.9%) were the most common psychological problems. Demographic factors such as religion 2.4 (95% confidence interval [CI] 1.1, 5.4) and occupation 2.5 (95% CI 1.1, 5.9) were associated with the morbidities. Likewise, obstetric factors such as place of delivery 1.5 (95% CI 0.8, 2.9) and type of delivery 1.9 (95% CI 1.0, 3.6) were also associated with various morbidities. CONCLUSIONS: The findings showed a high proportion of postpartum morbidities being reported in our study settings. These observation priorities a need of health program for early recognition, treatment and improving awareness of postpartum morbidities among near mothers.

Ocular Morbidity among Students in Relation to Classroom Illumination Levels.

OBJECTIVE: This cross-sectional study was done to find the prevalence of eye strain and other ocular morbidities among students in Udupi, Karnataka. METHODS: The study protocol included interview, visual acuity examination using Snellen chart, and measuring classroom illumination through lux meter. RESULTS: 26% students had visual morbidity and the most prevalent symptoms of eyestrain were headache (38.6%), watering of eyes (25.7%), pain around eyes (15.6%) and blurred vision (11.9%). 55.5% classrooms and 88.4% blackboards did not have proper illumination. CONCLUSION: Low classroom illumination levels may be a possible factor for development of visual morbidity.

Risk of oral cancer associated with gutka and other tobacco products: a hospital-based case-control study.

BACKGROUND: Although tobacco deaths rarely make headlines, tobacco kills one person every six seconds. Tobacco kills a third to half of all people who use it, on average 15 years prematurely. AIM OF THE STUDY: To study the risk of oral cancer associated with gutka consumption and other tobacco products. OBJECTIVE: (1) To find the association between gutka consumption and oral cancer. (2) To study the association between oral cancer and other tobacco products. METHODOLOGY: A case-control study of 134 cases and 268 controls, over a period of 5 months, from March 2013 to July 2013, was carried out at the Kasturba medical hospital in Manipal, India. The participants were personally interviewed by the investigator using a structured questionnaire on consumption of tobacco, poly-ingredient dip products, alcohol, dietary practices, oral hygiene practices and demographic status. RESULTS: Univariate logistic regression followed by multivariate logistic regression was done for identifying the risk factors and adjusted for the confounding variables. Analysis showed that gutka (<0.001, OR = 5.1 95% CI = 2.0-10.3), chewing tobacco (P < 0.001, OR = 6.0 95% CI = 2.3-15.7), supari (P < 0.001, OR = 11.4 95% CI = 3.4,38.2), betel quid (P < 0.001, OR = 6.4 95% CI = 2.6-15.5), bidi (P < 0.05, OR = 2.3 95% CI = 1.1-4.8) and alcohol (P < 0.001, OR = 3.7 95%CI = 1.8-7.5) had strong association with oral cancer upon adjustment. CONCLUSION: The study provided strong evidence that gutka, supari, chewing tobacco, betel quid, bidi and alcohol are independent risk factors for oral cancer.

Quality of Life among Persons with Physical Disability in Udupi Taluk: A Cross Sectional Study.

BACKGROUND: Disability is not just a health problem or attribute of individuals, but it reflects the problems individuals experience in their interaction with society and physical movements. Disabled persons remain neglected part of society and they also experience various barriers due to restriction of participation. OBJECTIVES: The aim was to assess the quality of life (QOL) of physically disabled persons, the impact of physical disability on activities of daily living (ADL) and to study the awareness about laws and facilities available for disabled persons. MATERIALS AND METHODS: A cross-sectional community based study was conducted among 130 physical disabled persons who were selected using convenience sampling technique. The WHO BREF scale was used to assess QOL, while assessment of ADL was done using Barthel Index. Socio-demographic assessment was done using Udai Pareek scale. SPSS version 15.0 was used to analyze data. Categorical variables were expressed as frequencies and percentages. As per guidelines physical, psychological, social, and environmental domain scores for WHO BREF scale were calculated. RESULTS: Among the study participants, 36.2% had a disability from birth that is, congenital. The second common cause of disability was found to be postpolio residual paralysis as it was found among 26.2% respondents. Other causes found were stroke/paralysis and accidents, in 19.2% and 18.5% respondents, respectively. Activities such as transfer, mobility, and stair climbing showed greater impact of physical disability. It was found that 11.5% respondents required help in one of the ADL. QOL score was found to be low under the psychological domain reflecting on negative feelings, bodily image, appearance, spirituality, and self-esteem of respondents. CONCLUSION: Physical disability had affected social participation as well as marriage of the respondents. However, it was found that very few of them are aware about facilities provided under persons with disability act.

Dermatological and respiratory problems in migrant construction workers of Udupi, Karnataka.

BACKGROUND: India being a developing country has tremendous demand of physical infrastructure and construction work as a result there is a raising demand of construction workers. Workers in construction industry are mainly migratory and employed on contract or subcontract basis. These workers face temporary relationship between employer and employee, uncertainty in working hours, contracting and subcontracting system, lack of basic continuous employment, lack basic amenities, and inadequacy in welfare schemes. OBJECTIVE: To estimate the prevalence of respiratory and dermatological symptoms among migratory construction workers. MATERIALS AND METHODS: This cross-sectional study was conducted in Manipal, Karnataka, among 340 male migratory construction workers. A standard modified questionnaire was used as a tool by the interviewer and the physical examination of the workers was done by a physician. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 15.0. RESULT: Eighty percent of the workers belong to the age group of 18-30 years. The mean age of the workers was 26 ± 8.2 years. Most (43.8%) of the workers are from West Bengal followed by those from Bihar and Jharkhand. The rates of prevalence of respiratory and dermatological symptoms were 33.2% and 36.2%, respectively. CONCLUSION: The migrant construction workers suffer from a high proportion of respiratory and dermatological problems.

Occupational stress and health-related quality of life among public sector bank employees: A cross-sectional study in Mysore, Karnataka, India.

BACKGROUND: Occupational morbidities have been estimated to cause an economic loss up to 10-20% of the gross national product of a country. It is an important cause of occupational morbidity and decreased quality of life (QOL) for the workers. AIM: The aim of the present study is to assess the level of occupational stress and its association with the QOL among the public sector bank employees. MATERIALS AND METHODS: The present study was conducted among employees of public sector banks in Mysore district, Karnataka, India. A cross-sectional study design was used for the study. Job stress was measured by using occupational stress index (OSI) scale questionnaire and health-related QOL was measured using the short form 12 (SF-12) questionnaire. The sample size estimated for the study was 526 and cluster random sampling technique was used. Chi-square test was used to find the association between the study variables and level of stress. Multiple linear regression model was used to find the determinants of health-related QOL among the study subjects. RESULTS: The total number of the study subjects was 546 out of which 57% were males and 43% were females. The proportion of study subjects reporting to be current smokers was 4.2% and almost all study subjects reported occasional alcohol consumption. The mean physical component summary (PCS) score and mental component summary (MCS) using the original United States standardization were 47.90 and 48.30, respectively. The individuals with mild stress scored higher in both PCS and MCS than the individuals who had moderate to severe stress levels. There was significant association of health related quality of life with the age of the respondent,presence of at least one morbidity and level of stress with health-related QOL. CONCLUSION: This study has shown an association of occupational stress with the QOL. There is a need for interventions aimed at mitigating the occupational stress among employees of the banking sector.

Studying risk factors associated with human leptospirosis.

BACKGROUND: Leptospirosis is one of the most under diagnosed and underreported disease in both developed and developing countries including India. It is established that environmental conditions and occupational habit of the individuals put them at risk of acquiring disease, which varies from community to community. Various seroprevalence studies across the world have documented emerging situation of this neglected tropical disease, but limited have probed to identify the risk factors, especially in India. OBJECTIVES: The objective of this study was to identify the environmental and occupational risk factors associated with the disease in Udupi District. MATERIALS AND METHODS: This population-based case-control study was carried out in Udupi, a District in Southern India from April 2012 until August 2012. Udupi is considered to be endemic for Leptospirosis and reported 116 confirmed cases in the year 2011. Seventy of 116 laboratory confirmed cases and 140 sex matched neighborhood healthy controls participated in the study. A predesigned, semi-structured and validated questionnaire was used for data collection through house to house visit and observations were noted about environmental conditions. Univariate analysis followed by multivariate analysis (back ward conditional logistic regression) was performed by using STATA version 9.2 (StataCorp, College Station, TX, USA) to identify potential risk factors. RESULTS: Occupational factors such as outdoor activities (matched odds ratio [OR] of 3.95, 95% confidence interval [CI]: 1.19-13.0), presence of cut or wound at body parts during work (matched OR: 4.88, CI: 1.83-13.02) and environmental factors such as contact with rodents through using the food materials ate by rat (matched OR: 4.29, CI: 1.45-12.73) and contact with soil or water contaminated with urine of rat (matched OR: 4.58, CI: 1.43-14.67) were the risk factors identified to be associated with disease. CONCLUSION: Leptospirosis is still considered as neglected disease in the district. Early diagnosis and prompt treatment of cases can save many lives. However, there is a need of integrated rodent control measures with great effort to increase awareness and education among subjects in controlling the disease.

Psychosocial Determinants of Health-Related Quality of Life of People Living with HIV/AIDS on Antiretroviral Therapy at Udupi District, Southern India.

BACKGROUND: Life expectancy of people living with HIV/AIDS (PLHA) on antiretroviral therapy has appreciably increased. However, psychosocial challenges pose a great threat to their health-related quality of life (HRQOL). The aim of this study was to determine psychosocial factors influencing health-related quality of life of PLHA on antiretroviral therapy. METHODS: A cross-sectional study was conducted using convenience sampling to select 226 PLHA at District hospital. Demographic information was collected using a semistructured questionnaire. HRQOL was assessed using WHOQOL-HIV Bref. The Hospital Anxiety and Depression Scale, CAGE scale, and Multidimensional Scale of Perceived Social Support were used. One-way ANOVA was applied. RESULTS: There was a significant difference in mean quality of life score with respect to level of anxiety in the physical (P < 0.001), psychological (P < 0.001), level of independence (P < 0.001), social relationships (P = 0.047), environment (P < 0.001), and spirituality domain (P < 0.001). Significant difference in mean quality of life score was observed with respect to level of depression in physical (P = 0.003), psychological (P = 0.036), level of independence (P = 0.017), social relationships (P = 0.019), and spirituality (P = 0.001). Friend support was positively associated with HRQOL in physical (P < 0.001), psychological (P < 0.001), level of independence (P = 0.013), social relationships (P < 0.001), environment (0.001), and spirituality domain (0.026). Family support was positively associated with HRQOL in physical (P = 0.001), psychological (P = 0.001), level of independence (P = 0.040), social relationships (P = 0.008), environment (0.001), and spirituality domain (0.026). A significant difference was observed with respect to affiliation to social organization in social relationships domain (P = 0.044). CONCLUSIONS: Psychosocial challenges including anxiety, depression, and social support impact upon all domains of HRQOL of PLHA.

HIV-TB coinfection: Clinico-epidemiological determinants at an antiretroviral therapy center in Southern India.

BACKGROUND: HIV-TB (tuberculosis) coinfection has emerged as a major public health threat. Given the multifactorial enabling environment in a resource-constrained setting like India, the consequences are of epidemic proportions. AIMS: This study was aimed at identifying the clinical and epidemiological determinants underlying HIV-TB coinfection. SETTINGS AND DESIGN: A retrospective review of patient records was done from the antiretroviral therapy center (ART) center at a district hospital in southern India between May and August 2012. MATERIALS AND METHODS: Secondary data of 684 patients on ART as well as pre-ART were collected between July 2008 and June 2012 and were analyzed. STATISTICAL ANALYSIS: Descriptive analysis, χ(2), and Wilcoxon signed rank tests were used with SPSS version 15.0 to draw significant statistical inferences. RESULTS: HIV-TB coinfection was diagnosed in 18.9% with higher prevalence among males (75.3%), in the sexually active age group 31-45 years (61.3%), with less than primary education (44.15%), who were married (56.1%), laborers (42.4%), from rural backgrounds (88.2%), and having low income-earning capacity (94.4%). Transmission was predominantly through the heterosexual route. The key entry point was the integrated counseling and testing center (ICTC) (47.4%). Pulmonary tuberculosis (58.8%) was predominantly found followed by extrapulmonary tuberculosis (38.2%) and both in 3.1%. A favorable outcome was observed in 69.3% of coinfected patients with 89.2% on ART and 97.2% currently on DOTS therapy. The Wilcoxon signed-rank test found significant association between rises in CD4 counts after the 6(th)-month follow up (P < 0.05). Coinfected patients had a case fatality rate of 25%. CONCLUSIONS: The prevalence of HIV-TB coinfection recorded in this sample was 18.86%. ICTC implemented by NACO emerged as an effective entry point, while Revised National Tuberculosis Control Program referred 1.6% (n = 11) of the patients to the ART center. Coinfection is associated with lower CD4 counts than those with HIV alone, which could translate into increased morbidity and progression of HIV to AIDS.

MPH program at Manipal University, India-experiences, challenges, and lessons learned.

BACKGROUND: The UAB-ITREOH program has initiated a skill-based MPH program at Manipal University (MU), India, in 2009, to address the critical need for trained public health professionals and build institutional public health training capacity in the country. METHODS: Funds from Fogarty have supported the curriculum development and specialized training of MU faculty to teach in the MPH program. RESULTS: The program has been successfully launched and is gaining momentum. The lessons learned from our experiences as well as several challenges faced from the initialization to execution of the program are described in the article. CONCLUSIONS: Government support is crucial for raising the profile of this program by accreditation, creating job opportunities and by recognizing these professionals as leaders in the public health sector.

Prevalence of Anemia among Tribal Women of Reproductive Age in Udupi Taluk, Karnataka.

CONTEXT: Anaemia is a major public health problem in India. Many studies have emphasized on prevalence of anaemia among general population. This study has focussed to address the prevalence of anaemia among the tribal population in Udupi taluk. Anaemia among women in the reproductive age group is one of the causes for maternal morbidity and mortality in India. AIM: To estimate the prevalence of anemia among tribal women (aged 15 to 49 years). SETTINGS AND DESIGN: A Community based cross sectional study was conducted among tribal women aged 14-49 years in Udupi taluk, Udupi district, Karnataka. METHODS AND MATERIAL: A cross sectional study during July 2012 to August 2012 was conducted. A sample size of 170 was calculated taking into consideration a relative error of 15% and the prevalence of anemia in Karnataka as 51% (as per the NFHS-3). STATISTICAL ANALYSIS USED: Univariate and multivariate analysis was used to analyse the data using SPSS 15. RESULTS: The study sample had a mean hemoglobin value of 11.3 g/dL with 95% CI of (11 - 11.6), with a standard deviation of 2g/dL. The study reveals that in the sample of tribal women in the age group of 15-49 years, the prevalence of anemia was 55.9%. Among the subjects, 6 (3.5%) were severely anemic, 33 (19.4%) were moderately anemic and 56 (32.9%) were mildly anemic. CONCLUSIONS: This study calls for an appropriate action and intervention in this tribal population to treat and prevent anaemia.

Secondhand smoke exposures in indoor public places in seven Asian countries.

Exposure to secondhand smoke (SHS) is a major threat to public health. Asian countries having the highest smoking prevalence are seriously affected by SHS. The objective of the study was to measure SHS levels in hospitality venues in seven Asian countries and to compare the SHS exposure to the levels in Western countries. The study was carried out in four types of related hospitality venues (restaurant, café, bar/club and entertainment) in China, India, Japan, Korea, Malaysia, Pakistan and Sri Lanka. Real-time measurement of particulate matter of <2.5microm aerodynamic diameter (PM(2.5)) was made during business hour using a handheld laser operated monitor. A total of 168 venues were measured in seven countries. The average indoor PM(2.5) level was 137microg/m(3), ranging from 46microg/m(3) in Malaysia to 207microg/m(3) in India. Bar/club had the highest PM(2.5) level of 191microg/m(3) and restaurants had the lowest PM(2.5) level of 92microg/m(3). The average indoor PM(2.5) level in smoking venues was 156micro/m(3), which was 3.6 times higher than non-smoking venues (43microg/m(3)). Indoor PM(2.5) levels were significantly associated with country, type of venue, smoking density and air exchange rate (p<0.05). In the seven Asian countries, PM(2.5) levels were high due to SHS in public places. The current levels are comparable to the levels in Western countries before the adoption of smoke-free policy. Since Asian country has high prevalence of SHS in public places, there is an urgent need for comprehensive smoke-free regulation in Asian countries.