Comparison of complete and spatial sampling frames for estimation of the prevalence of hypertension and diabetes mellitus.

A complete sampling frame (CSF) is needed for the development of probability sampling structures; utilisation of a spatial sampling frame (SSF) was the objective of the present study. We used two sampling methods, simple random sampling (SRS) and stratified random sampling (STRS), to compare the prevalence estimates delivered by a CSF to that by a SSF when applied to self-reported hypertension and diabetes mellitus in a semi-urban setting and in a rural one. A CSF based on Geodatabase of all households and all individuals was available for our study that focused on adults aged 18-69 years in the two settings. A single digitized shapefile of solely household regions/structures as SSF was developed using Google Earth and employed for the study. The results from the two sampling frames were similar and not significantly different. All 95%CI calculations contained the prevalence rates of the two medical conditions except for one occasion based on STRS and CSF. The SRS based on CSF showed a minimum 95% CI width for diabetes mellitus, whereas SSF showed a minimum 95% CI width for hypertension. The coefficient of variation exceeded 10.0% on six occasions for CSF but only once for SSF, which was found to be as efficient as CSF.

Effectiveness of the ChAdOx1 nCoV-19 Coronavirus Vaccine (CovishieldTM) in Preventing SARS-CoV2 Infection, Chennai, Tamil Nadu, India, 2021.

We estimated the effectiveness of two doses of the ChAdOx1 nCoV-19 (Covishield) vaccine against any COVID-19 infection among individuals ≥45 years in Chennai, Tamil Nadu, India. A community-based cohort study was conducted from May to September 2021 in a selected geographic area in Chennai. The estimated sample size was 10,232. We enrolled 69,435 individuals, of which 21,793 were above 45 years. Two-dose coverage of Covishield in the 18+ and 45+ age group was 18% and 31%, respectively. Genomic analysis of 74 out of the 90 aliquots collected from the 303 COVID-19-positive individuals in the 45+ age group showed delta variants and their sub-lineages. The vaccine's effectiveness against COVID-19 disease in the ≥45 age group was 61.3% (95% CI: 43.6-73.4) at least 2 weeks after receiving the second dose of Covishield. We demonstrated the effectiveness of two doses of the ChAdOx1 vaccine against the delta variant in the general population of Chennai. We recommend similar future studies considering emerging variants and newer vaccines. Two-dose vaccine coverage could be ensured to protect against COVID-19 infection.

Application of the Lower Extremity Functional Scale and Its Correlation with Lymphedema Health-Related Quality of Life on Lower Limb Filarial Lymphedema Patients.

Introduction: This study carried out as a part of the lymphedema (LE)-osteoarthritis project to know the feasibility and applicability of lower extremity functional scale (LEFS) and LE health-related quality of life (LEHRQoL) among filarial LE patients of the lower extremity. Materials and Methods: Following inclusion and exclusion criteria 30 LE patients and 30 controls were recruited in the study. After obtaining informed written consent, Tamil version of the two "self-reporting assessment tools" LEFS and LEHRQoL were applied to all the participants by two examiners independently. Feasibility was assessed by the time schedule. Internal consistency and the correlation between two examiners was assessed by calculating Cronbach's alpha and Karl Pearson correlation coefficient and Spearman rank correlation respectively. Results: The mean time taken for completing the LEFS and LEHRQoL questionnaire was 5 minutes and 2 seconds and 12 minutes and 8 seconds respectively. Internal consistency reliability assessment showed good internal consistency for both the examiners (Cronbach's alpha 0.816 and 0.812). There was a strong positive correlation for the cases (r = 0.956, p < 0.001; r = 0.908, p < 0.001) and controls (r = 0.992, p < 0.001; r = 0.985, p < 0.001) between the two examiners. Conclusions: LEFS and LEHRQoL were well accepted among filarial LE patients and the patients with low literacy were able to respond without any difficulty to both assessment tools. LEFS was found suitable for the assessment of lower extremity functions of the LE patients as in other diseases affecting the lower limb and it also indirectly brought out the impact on the QoL.

Prevalence of risk factors for non-communicable diseases in a rural tribal population of Mokokchung, Nagaland, India.

Background: Non-communicable diseases (NCDs) are the leading cause of mortality in India. The northeastern part of India has a high burden of NCDs. However, data on the prevalence of risk factors for NCDs in the rural tribal population of Nagaland are limited. We estimated the prevalence and awareness level of risk factors for NCDs in the rural population of Mokokchung district, Nagaland. Methods: In a cross-sectional survey, we selected 472 subjects aged 25-64 years, stratified by age and sex, in 20 villages, using a cluster sampling technique. The WHO STEPS tools were used to collect data on behavioural risk factors, and anthropometric, blood pressure and capillary glucose measurements. The proportion of subjects with each NCD risk factor was determined overall and in various age and sex subgroups. Results: The 472 subjects had a median age of 44.5 years, 92 (19.5%) reported current smoking and 75 (15.9%) reported current alcohol use. Among 236 males, 90 (38.1 %) were current smokers and 65 (27.5%) were current alcohol users, whereas of the 236 females, only 2 (0.8%) and 10 (4.2%) were current smokers and current alcohol users, respectively. The use of smokeless tobacco was common among both males (139/236; 58.9%) and females (117/ 236; 49.6%). Inadequate intake of fruits and vegetables was reported by 189 (80.1%) males and 221 (93.6%) females. Insufficient physical activity was observed only among 16 (3.4%) participants. Prevalence of hypertension and a body mass index of 23.0-27.49 kg/m2 was 43.2% and 32.4%, respectively. Conclusions: We observed a high prevalence of behavioural risk factors for NCDs and of hypertension in rural tribal people in Nagaland. The primary healthcare system needs to be strengthened in this area to improve detection and management of hypertension. Mass and print media campaigns and provision of cessation services may also be helpful.

A cross-sectional study on prevalence of chronic obstructive pulmonary disease (COPD) in India: rationale and methods.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable chronic respiratory disease, which affects 210 million people globally. Global and national guidelines exist for the management of COPD. Although evidence-based, they are inadequate to address the phenotypic and genotypic heterogeneity in India. Co-existence of other chronic respiratory diseases can adversely influence the prognosis of COPD.India has a huge burden of COPD with various risk factors and comorbid conditions. However, valid prevalence estimates employing spirometry as the diagnostic tool and data on important comorbid conditions are not available. This study protocol is designed to address this knowledge gap and eventually to build a database to undertake long-term cohort studies to describe the phenotypic and genotypic heterogeneity among COPD patients in India. OBJECTIVES: The primary objective is to estimate the prevalence of COPD among adults aged ≥25 years for each gender in India. The secondary objective is to identify the risk factors for COPD and important comorbid conditions such as asthma and post-tuberculosis sequelae. It is also proposed to validate the currently available definitions for COPD diagnosis in India. METHODS AND ANALYSIS: A cross-sectional study will be undertaken among the populations of sub-urban areas of Chennai and Shillong cities, which represent the Southern and Northeastern regions of India. We will collect data on sociodemographic variables, economic characteristics, risk factors of COPD and comorbidities. The Global Initiative for Obstructive Lung Disease (GOLD) and Global Initiative for Asthma (GINA) definitions will be used for the diagnosis of COPD and asthma. Data will be analysed for estimation of the prevalence of COPD, asthma and associated factors. ETHICS AND DISSEMINATION: This study proposal was approved by the respective institutional ethics committees of participating institutions. The results will be disseminated through publications in the peer-reviewed journals and a report will be submitted to the concerned public health authorities in India for developing appropriate research and management policies.

Utilization of Services Under Janani Shishu Suraksha Karyakram for Institutional Deliveries in the Public Sector Facilities, Sirmaur District, Himachal Pradesh, India.

BACKGROUND: Janani Shishu Suraksha Karyakram (JSSK) was initiated in 2011 to reduce the out of pocket expenditure for pregnant women. We estimated the proportion of mothers who received JSSK benefits and out of pocket expenditure (OOP) if any in Sirmaur, Himachal Pradesh. MATERIALS AND METHODS: We did cross sectional survey in public sector facilities among 156 consecutive mothers using structured questionnaire. We computed the proportion of mother who received the benefits and the median OOP expenditure. RESULTS: Among 156 mothers surveyed, 93 (60%) received the full benefits during hospital stay and 29 (19%) received full transport benefits. Free diagnostics and drugs were given to 149 (96%) and 134 (86%) respectively. Overall, 63 (40%) had median OOP Rs 210 during hospitalization and 127 (81%) had median OOP of Rs 420 during transport. CONCLUSION: JSSK benefitted the mothers utilizing the public sector facilities however drugs, consumables and transport contributed to the OOP expenditure.