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Introduction: Alzheimer Questionnaire (AQ) and Montreal Cognitive Assessment (MoCA) are tools for assessment of cognitive impairment. MoCA is a common tool for screening of cognitive impairment but it requires trained personnel. AQ questionnaire is informant-based, simple and less time consuming with or without the involvement of trained personnel. Aim: To estimate the prevalence of cognitive impairment and to find out the accuracy of AQ compared to MoCA in Cognitive Impairment screening among elderly population in an urban area of West Bengal. Materials and Methods: The Prospective cross-sectional study was conducted in urban field practice area of All India Institute of Hygiene and Public Health, Kolkata among 140 randomly selected elderly population from June to September 2019. Accuracy of AQ with MoCA tool as gold standard in screening cognitive impairment was analysed by Cohen’s Kappa, Receiver Operating Characteristics (ROC) Curve, Spearman rho Coefficient along with sensitivity, specificity, predictive values and likelihood ratio was obtained. Results: Prevalence of cognitive impairment using MoCA and AQ was 40% (95%CI=31.8-48.6) and 36.4% (95% CI=28.5- 45.0), respectively. AQ and MoCA showed good agreement (Cohen’s kappa, κ=0.834; 95% CI=0.739-0.928). The AQ and MoCA showed a strong negative correlation (spearman’s rho=-0.709; 95%CI=0.764-0.884, p-value <0.001). Considering MoCA as gold standard, AQ showed sensitivity of 85.7% (95% CI=74.2-92.6), specificity of 96.4% (95% CI=89.9-98.7) for cognitive impairment screening and the Positive predictive value of this tool was 94.1% (95% CI=84.0-97.9%). The Youden index of 0.821 showed highest sum of sensitivity and specificity of AQ tool at 4.5 score to anticipate cognitive impairment. Conclusion: AQ is equally effective as MoCA to screen cognitive impairment among elderly at the community level. AQ can be used even by grass root level health workers without involvement of trained personnel. So, community level screening of elderly for cognitive dysfunction can be made even in resource poor settings. Early identification and referral of elderly with cognitive dysfunction will help them in better living. [ABSTRACT FROM AUTHOR]

Introduction: Globally, one-third of current health expenditure had been out-of-pocket expenditure (OOPE). The health system financing of almost all low- and middle-income countries including India rely heavily on out-of-pocket (OOP) payments for health care. OOPE on health payments is particularly hard on any community, especially the poor leading to incomplete or even no treatment during their ill health. This study estimated OOPE among residents of a rural community in West Bengal and explored the associated factors with high OOP expenses. Methods: A community-based cross-sectional study was conducted in a rural community in Singur, West Bengal from June 2019 to February 2020. The study was done among 398 villagers selected from 15 clusters or villages. Households were randomly selected in each village. All members of the selected households were interviewed. SPSS was used for data analysis both for descriptive and inferential statistics. Results: Only 14.6% of morbid persons had catastrophic expenditure. The incidence of catastrophic expenditure was higher among those who opted for private practitioners and or ayurveda, yoga and naturopathy, unani, siddha, and homeopathy (AYUSH) facilities. There was zero catastrophic expenditure for the unqualified sector. There was an increasing trend of OOP payments among the lower socioeconomic groups. Again, low-income individuals had a higher share in cumulative expenditure (Gini coefficient of 0.35). Most of the participants (78.4%) had no health insurance coverage. Conclusion: Promotion for higher utilization of public health facilities may reduce the burden of OOP expenses. Government health insurance schemes must be widened with the inclusion of coverage of outpatient services. Integrating AYUSH services in the public sector is another option to reduce OOP expenses. [ABSTRACT FROM AUTHOR]

Context: Anemia is a serious public health concern especially in women of reproductive age (WRA) as it causes a high burden of morbidity and mortality and persists through intergenerational cycle. As most of the risk factors are preventable, a thorough understanding of its risk factors is necessary to design better interventions. Aims: Current study aimed to estimate the burden of anemia as well as explore determinants of various grades of anemia among WRA in a rural area. Settings and Design: A community-based cross-sectional study was conducted among non-pregnant, non-lactating women of reproductive age in rural field practice area of All India Institute of Hygiene and Public Health. Methods and Materials: House to house visit was conducted for interviewing with pre-designed pre-tested questionnaire along with blood hemoglobin and anthropometric measurement. Statistical Analysis Used: Descriptive statistics and test of significance like multinomial logistic regression and Kruskal-Wallis test (with post-hoc) were used. Results: Majority (70.8%) of participants were anemic. Proportion of mild, moderate, and severe anemia were 24.16%, 37.5%, and 9.16%, respectively. Different levels of anemia were significantly associated with higher age, lower education, poor iron-rich food intake, lack of dietary diversity, and adiposity. Significantly low hemoglobin level in both underweight and obesity was noticed suggesting U shaped relationship between BMI and anemia. Conclusion: Periodic screening for anemia among WRA especially in both extremes of malnutrition, i.e., undernutrition and obesity should be considered at the policy level. Year-round behaviour change communication campaigns must be carried out for the promotion of necessary food groups in diet. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent Hypertension (HTN) is one of the most alarming public health problems and is a potential risk factor for noncommunicable diseases as asymptomatic, mostly remain undiagnosed. Simple anthropometric indicators acting as preliminary screening tool to predict HTN among adolescents is the need of hour. Aim: The present study was undertaken to find out the magnitude of pre HTN and HTN among adolescent school students of North 24 Parganas and to find out the variation of blood pressure with different anthropometric parameters. Materials and Methods: A cross-sectional study was carried out from June to September, 2019 among 369 adolescent school students of class VIII to XII in two Government higher secondary schools, selected conveniently, in North 24 Parganas. Data was collected by face to face interview, blood pressure recording and anthropometric measurements in the selected schools was done. Data was analysed using SPSS version 16.0. Results: Among 369 participants, 189 (51.2%) were boys and 180 (48.8%) were girls. Mean Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) among boys were 110.2 (±14.9), 68.0 (±9.3) and among girls 113.1 (±14.3), 71.2 (±9), respectively. Overall HTN was found to be 7.0% (6.3% in boys and 7.8% in girls) and pre HTN was 13.8% (12.2% in boys and 15.6% in girls). There were significant (p<0.05) positive correlation of SBP and DBP with BMI (r=0.692; r=0.673), Body fat percent (r=0.686; r=0.676,), Waist Circumference (WC) (r=0.708; r=0.640), Neck Circumference (NC) (r=0.593; r=0.509,). HTN was significantly associated with physical activity and salt intake (p<0.05). Conclusion: As a rising trend of HTN was found among adolescents, early lifestyle modification and strengthening of school health setup using simple anthropometric measures are recommended for early detection of adolescent HTN and to prevent detrimental consequence. [ABSTRACT FROM AUTHOR]