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Background: Acute diarrhoeal diseases (ADD) account for a large number of preventable deaths in India, especially in children less than five years who are more at risk than adults with respect to the degree of dehydration and complications. (1) To measure the incidence of ADD among children under 5 years; (2) Determine risk factors associated among children; (3) Study treatment-seeking behaviour of their mothers. Community-based, prospective, longitudinal study conducted in an urban area of Goa. Material and Methods: 250 children enrolled in the study with their mothers by stratified random sampling technique, conducted house-to-house visits every three months and mothers were interviewed with pre-tested semi-structured questionnaire. The duration of study was one year from January to December 2018. Data entered using EpiData Entry Client®, Analysed using SPSS® software version 22. Student's t-tests and Chi-square tests were used. Results: The incidence of ADD was 0.124 episodes/child/year. Significant association was noted between ADD in children and certain socio-demographic factors like child's sex, birth order, birth weight, immunization status, malnutrition, mother's age group, mother's education, and mothers' hygiene practices. Conclusions: Efforts should be made to educate all mothers about the seeking timely treatment, awareness about home-based management and their types, awareness of ORS, zinc, importance of hygienic practices like hand washing for mother and child. [ABSTRACT FROM AUTHOR]

Introduction: Mid-upper arm circumference (MUAC) measures the arm muscle and fat area. The use of MUAC as a screening measure for assessing undernutrition has the following advantages; it makes use of a simple equipment, is easy to carry at the field sites, and requires minimal training. In India, "mid-upper arm circumference" is widely used and accepted in many nutritional programs. Objectives: This study was conducted with the primary objective to compare different anthropometric parameters of children and to validate the usefulness and limitations of MUAC to screen out undernourished children. Subject and Methods: Anthropometric measurements were recorded for all the anganwadi centers of the selected sub-center that comes under the field practice area of our department. The measurements like weight, height, MUAC were done according to the standard guidelines as per WHO, and further, calculations were done with the help of "Anthro software 3.2.2." Comparisons were done between categorization of MUAC tape and Weight-for-Height Z-scores (WHZ), and hence, the sensitivity and specificity of the MUAC tape to screen the malnourished child were found out. Results: Sensitivity of MUAC to categorize a child in red/yellow was only 9.03%, negative predictive value (NPV) was 40.75%, specificity came 95.10%, and positive predictive value was 73.68% on taking WHZ as the gold standard. Conclusion: MUAC has a limited role in screening out an undernourished child (red/yellow category), whereas it has a good role in screening healthy children (green category). [ABSTRACT FROM AUTHOR]

Background: Undernutrition is an important public health problem affecting one-third of under five-year-old children in India. Objectives: To assess the nutritional status of under five-year-old children along with child feeding practices. Materials and Methods: We adopted a systematic sampling procedure to carry out this community-based, cross-sectional study in all the districts of Haryana. Data was collected on socioeconomic and demographic particulars along with anthropometric measurements. Analysis was done using SPSS Windows 23. Results: The overall prevalence of stunting, underweight, and wasting was 34%, 27.5%, and 11%, while that of severe undernutrition was 11%, 8%, and 3%, respectively. The odds of underweight were significantly higher among children of the Muslim religion, children of scheduled caste, children of illiterate mothers, lower per capita income, HHs without electricity, landless HHs, low birth weight, no ANC care, and those early ages at complementary feeding. Stunting was significantly higher among children whose mothers were illiterate, children whose fathers were laborers, among landless HHs, with no separate kitchen and lower birth weight, while wasting was higher among children of Muslim religion, children of scheduled caste, with no sanitary latrine facility, low-birth-weight children and early initiation of complementary feeding. Conclusions: Undernutrition is observed to be associated with religion, community, education of mother, per capita income, land holding status, birth weight, and age at complementary feeding. Thus, improving maternal nutrition can improve birth weight, improving maternal knowledge about child feeding, and the household's socio-economic status may improve the nutritional status of children. [ABSTRACT FROM AUTHOR]

Background: Identification of mental health disorders during childhood is crucial for healthy 'adult roles' in the society, so this study aimed to estimate the magnitude of 'any mental health disorder' and to find out its correlates among children attending the pediatric out-patient department (OPD) of a medical college in West Bengal and to estimate parental stress among their parents. Materials and Methods: It was a descriptive cross-sectional study done in the pediatric OPD of Burdwan Medical College, West Bengal, during July--December, 2021. The calculated size of 288 children aged between 4 and 12 years and attending with either of their parents was selected through systematic random sampling. One of their parents (preferably mother) was interviewed using a schedule, containing a pre-validated pediatric symptom checklist and parental stress scale. Ethical clearance was obtained from the Institutional Ethics Committee. Data were analyzed using SPSS-v23. Results: The median age of the children was 7 years (5--8 y.). The majority of them were male (57.6%), lived in urban areas (59.0%), and lived in joint families (57.6%). One-fifth (20.5%) of the children were found to have any mental health disorder (AMHD). Living in an urban area (aOR = 2.5, 95% CI: 1.1--5.7), belonging to a nuclear family (aOR = 3.6, 95% CI: 1.7--8.1), and belonging to a family with social problems (aOR = 7.8, 95% CI: 2.3--27.2) were significant correlates of AMHD. Parental stress [median: 60 (55--63)] was found significantly higher (P < 0.001) among parents of children with AMHD as compared to the parents of others. Conclusion: The magnitude of AMHD was high in this study, indicating toward the necessity of implementing opportunistic screening and appropriate public health action. [ABSTRACT FROM AUTHOR]

Background: To compare the morbidity and treatment-seeking pattern of low birth weight (LBW) and normal birth weight (NBW) infants during the first six months. Material and Methods: A prospective cohort study was conducted in the service areas of eight urban primary health centers of Puducherry from October 2019 to July 2021. Details of LBW and sex-matched NBW infants were obtained from the birth registers of selected PHCs. Data were collected using a structured interview schedule on completion of the first, third, and sixth months at their homes. For comparison, Mid-p exact test was used for incidence rates, t-test/Mann-Whitney for continuous variables and the Chi-square/Fisher's exact test for the categorical variables. Results: Ninety-four pairs of LBWS and NBW infants were recruited. The incidence of morbidity during the first six months among LBW and NBW infants was 37.5 and 33.3 episodes per 100 child months, respectively (P value 0.118). Though the incidence of all-cause morbidity was similar, skin infections were significantly higher among LBW (3.10 vs 1.21 per 100 child months, P = 0.04). The incidence of all-cause morbidity was high in LBW infants with poor weight gain. Conclusion: Birth weight was associated with all-cause morbidity during the first three months. However, this association varied in age points and infants' weight gain. [ABSTRACT FROM AUTHOR]

Background: Immunization is a cost-effective weapon against vaccine preventable diseases. Children of migrant workers suffer from lack of immunization because of frequent shift of places, poor knowledge, and low socioeconomic status. To assess the immunization status of children 12--36 months of age of migrant workers and factors associated it. To identify the reasons for non-immunization or partial immunization among these children. Material and Methods: A cross-sectional study was conducted among 500 migrant workers' children aged 12--36 months residing in Urban Bangalore east from February 2019 to August 2020. A cluster sampling method was incorporated. The data were collected using pre-tested semi-structured questionnaire. Data were analyzed using Epi-info™ Version 7.2.1 and SPSS version-21. Data were summarized in percentages, mean, standard deviation, and logistic regression. Results: The mean age of the children was 25.2340 ± 8.42 months. Out of 500 children, 88.60% were fully immunized, 11.40% were partially immunized, and no child was unimmunized. Significant predictors of immunization status of children were education of father and immunization card. Common reasons for dropout were inconvenient time (80.70%), unaware of need (77.19%), and busy schedule of parents (75.44%). The dropout rate of BCG to MR-1, Penta-1 to Penta-3, and Penta1to MR-1 was 6.49%, 0.85%, and 2.12%, respectively. Conclusions: Immunization coverage in the present study was 88.60%. Inconvenient time was the main reason behind partial immunization. [ABSTRACT FROM AUTHOR]

Background: India experienced three coronavirus disease (COVID-19) waves, with the third attributed to the highly contagious Omicron variant. Before the national vaccination rollout for children above 6, understanding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) positivity in the pediatric population was essential. This study aims to assess the burden of Covid-19 infection and to estimate the seroprevalence in children aged 6 to 14 years in the state of Karnataka. Material and Methods: We surveyed 5,358 children aged 6-14 across Karnataka using 232 health facilities, from June 6 to 14, 2022. We determined the sample size using the PPS (Population Proportional to Size) technique and employed cluster sampling. We tested all participants for SARS-CoV-2 IgG with an enzyme-linked immunosorbent assay (ELISA) kit and SARS-CoV-2 RNA with reverse transcription-polymerase chain reaction (RT-PCR). We sequenced samples with a cycle threshold (CT) value below 25 using whole genomic sequencing (WGS). Result: We found an adjusted seroprevalence of IgG at 75.38% statewide, and we found 0.04% of children RT-PCR positive for COVID-19. We determined a case-to-infection ratio of 1:37 and identified the SARS-CoV-2 strains as Omicron, BA.5, and BA.2.10. Conclusion: The study showed a high seroprevalence of IgG among children with low active infection. Omicron, BA. 5, and BA. 2.10 variants were detected through WGS. [ABSTRACT FROM AUTHOR]

Background: Stunting is a significant public health problem in childhood in developing countries. Sustainable Developmental Goals have mandated that each country reduce stunting by 50% by 2030. However, despite various nutrition and health programs, India still faces a massive burden of stunting. With the increasing urbanization in the country and its typical challenges related to health and nutrition, chronic malnutrition is a massive problem in urban areas, especially among people in the lower wealth quintile. Hence, current study has attempted to estimate the prevalence of stunting among children (0–6 years) and its determinants. Methodology: A cross-sectional study was conducted in the Urban Anganwadi centers of Rishikesh, Uttarakhand, for 6 months, from December 2021 to May 2022. Three hundred ten children from 13 selected Anganwadi centers were included using random sampling. Data were collected using a semi-structured validated and pretested questionnaire using Epicollect 5.0. Data were analyzed using the SPSS 23.0 version to estimate the prevalence of stunting and associated risk factors. Results: Out of 310 participants, 71 (22.9%) were stunted. Female children were slightly more stunted (24.7%) than males (21.1%). Maximum stunting (33.4%) was observed among children in the 5–6-year age group, and children with higher birth order were much more stunted. Stunting was reported more in children who were breastfed on demand (33.8%) than those fed every 2 hours (19.3%). Conclusion: Stunting prevalence in urban areas of Rishikesh is 22.9%, which is almost similar to the state average of 24.3% for urban areas; however, it was higher in comparison to the SDG 2030 global target of ending malnutrition of all forms. Stunting was significantly associated with feeding on demand and eating frequency less than twice a day. [ABSTRACT FROM AUTHOR]

Backgrounds: The Universal Immunization Program of India is one of the most cost-effective interventions in public health. Missing or delaying vaccination may elicit an uncertain immune response in the body, making the population susceptible to vaccine-preventable diseases. The objectives of this study were to determine the coverage of newborn immunization for birth doses under the National Immunization Schedule and its epidemiological determinants in the rural areas of the Dehradun district, Uttarakhand. Materials and Methods: A community-based cross-sectional study was conducted for a period of one year with a sample size of 570. World Health Organization (WHO) 30 Cluster sampling technique was used with 19 children in each cluster. The data on determinants were collected using a semi-structured, pre-designed schedule through a house-to-house survey. Multivariate analysis was conducted to identify factors associated with immunization coverage, taking the significance level as P < 0.05. Results: The coverage of the Bacillus Calmette-Guérin vaccine, oral polio vaccine zero dose and hepatitis B birth dose were 100%, 91.9%, and 58.8%, respectively in the study area with an overall prevalence of incomplete coverage of newborn immunization as 42.5%. The most cited reason for children being unimmunized with birth doses was the unavailability of vaccines at the birthplace center (29.6%). Conclusions: The prevalence of incomplete coverage of newborn immunization was quite high, which was undermining the holistic approach of the National Immunization Program. Vaccine availability and accessibility at the birthplace with capacity building and training of the healthcare workers may be considered to ensure coverage of birth doses. [ABSTRACT FROM AUTHOR]

Childhood injuries are a major public health challenge in India and globally. This systematic review was conducted to understand the burden and spectrum of childhood injuries, with a focus on unintentional injuries, among children 5-14 years of age and to suggest approaches to prevention that can be adopted in the Indian context. This systematic review was conducted with the standard approach and use of keywords. A total of 33 studies which were found to be relevant were analyzed. Road traffic accidents (RTAs) contribute to nearly 85% of all unintentional injuries and related deaths and 90% of disability-adjusted life years (DALYs) lost in developing countries. Poor traffic regulation, heavy traffic load, and poor skill of identifying the dangerous road crossing sites make the children's age group vulnerable and prone to RTA. Children with poor skill of identification and response to dangerous road crossing sites, along with heavy unregulated traffic were found to be the major reasons for such accidents and make this age group more vulnerable. Public health-based prevention approaches need to be based upon legislation, regulation, and enforcement, as well as environmental modification, education and skill development, emergency medical care using levels of prevention, and principles of targeted prevention to effectively address child health challenges. Addressing child injuries should be a key component of all endeavors aimed at enhancing child mortality and morbidity rates, as well as the overall welfare of children, both at the national and global levels. It is imperative to prioritize policies focused on preventing unintentional injuries across all age groups, with particular attention to children. [ABSTRACT FROM AUTHOR]

Background: To assess the effectiveness of educational intervention to reduce the weight of school bags. Material and Methods: The study design was one group pre- and posttest experimental Research design. Place and Duration of Study: Government Senior Secondary School Dhanas, Chandigarh, and Shri Guru Harkrishan Model Senior Secondary School Sector-38D, Chandigarh (A private school) between July and November 2018. Names of the schools can be avoided. Total 760 students from selected sections nursery to 10th class of school were enrolled in the study. At baseline and end line weight of children, school bags and its content were weighed using weighing scale. Length of bag strap, breath of bag, torso of children, and their shoulders size were measured by measuring tape. Bag carrying style, posture, etc., were observed by observation checklist. Interviewed children (5th to 10th class) were using Nordic musculoskeletal questionnaire for musculoskeletal system assessment. Educational intervention was provided to the children for one month to reduce weight of school bag by teaching in assembly and displaying the charts in school. (Use of softbound thin textbooks, breaking thin books in 2-3 thin softbound books, use lightweight bag, pencil box, lunch box, and water bottles. Pack bag as per timetable.) Result: The result revealed that heavy school bags were carrying 69.7% children from government school and 80.2% from private school. Children carrying heavy bags reported musculoskeletal problems 5 times higher than their counterparts. After intervention, there was significant reduction in the weight of school bags (P < 0.001 as per paired t-test). Provide the weight of the bags before and after intervention in addition to the P value. Conclusion: Children carrying heavy bags were suffering from musculoskeletal problems. Intervention helped in reducing the weight of school bag. [ABSTRACT FROM AUTHOR]

Context: In India, pneumonia deaths in the past decade show a decreasing trend in the child mortality rate from 74.6 to 45.4. However, NFHS-5 records an increase in prevalence to 2.8% from 2.7% in NFHS-4. The childhood pneumonia control strategies focus on strengthening the health system, skill-building health workers, counseling, and creating awareness about promoting healthy behaviors regarding the management of sick children. Aims: The study attempts to understand "caregivers" care-seeking behavior and the management of childhood pneumonia. Setting and Design: The study was conducted in the Akkalkuwa block of Nandurbar district, Maharashtra, India. We used episodic interviews, asking caregivers to recollect specific events linked to the need for treatment. Methods and Material: A total of 11 in-depth interviews of mothers were conducted whose under-five children had pneumonia in the past year. These interviews used vignettes from real pneumonia cases to discuss community priorities for health care and actions taken to improve child's health. In addition, the qualitative data from the in-depth interviews were thematically analyzed. Result: Cough, breathlessness, and disturbance in the routine schedule of the child were the major symptoms to identify pneumonia (vavlya) among children. Branding on the stomach, oil massage, and jadi-buti were commonly observed phenomena to seek help. Low priority, the influence of traditional healers and herbal medicines, and the inaccessibility of quality healthcare services were the main factors that led to the child's treatment. Conclusion: Culturally appropriate activities are to be imparted on recognition of symptoms and appropriate care seeking, and community health workers need capacity building. [ABSTRACT FROM AUTHOR]

In India, children do not get diagnosed with tuberculosis (TB) for reasons such as lack of screening modality at the health-care settings, inadequate sputum sample, and low detection rate. This study aims to assess various modalities for diagnosis of pediatric TB and their cost-effectiveness. Cost-effectiveness was found for various diagnostic modalities for TB diagnosis in children of India below 15 years of age. TrueNat MTB was the intervention being compared to GeneXpert MTB and sputum microscopy. Evidence pertinent to effectiveness and cost per test, and health benefits in terms of disability adjusted life years were researched and documented. Modeling a cohort of children through a decision tree and assimilating costs and disability-adjusted life years (DALYs) at each step gave results in the form of cost-effectiveness. Interventions were compared by calculating the cost-effectiveness ratio. The results revealed that TrueNat is more cost effective (Rs. 9450/DALY averted) compared to GeneXpert MTB/RIF (Rs. 9750/DALY averted). The incremental cost effectiveness ratio of TrueNat with respect to GeneXpert was found to be Rs. 5925 per DALY averted. Diagnosis through TrueNat point of care (POC) will avert 962 more DALYs compared to GeneXpert. As is evident from the results, TrueNat does alleviate disability caused by TB in children as more DALYs are averted. At an additional cost of Rs. 5925 to avert one DALY, which is below the gross domestic product (GDP) per capita for India (for 2021, it was $2277), TrueNat can have significant health benefits. [ABSTRACT FROM AUTHOR]

High burden of acute malnutrition among children less than 5 years is a major public health problem in India. A "Two-days National Consultation on Addressing Acute Malnutrition" was organized to gather experiences and evidence from 13 states of India on prevention and management of acute malnutrition among children and documenting viewpoints from experts and government counterparts on the same. The consultation centered around five key themes of addressing acute malnutrition: 1) capacity building, 2) strengthening screening, 3) nutritional care of wasting, 4) tracking progress, and 5) scale-up. The paper highlights the experiences and key recommendations around the above key themes. It emerged that there is a need to further accelerate the efforts toward strengthening existing platforms and services to address acute malnutrition among children. Regular trainings of the frontline workers, increased convergence, regular monitoring, and continued service delivery during the pandemic should be undertaken for better outcomes. [ABSTRACT FROM AUTHOR]

Background: Percentile curves are often used to assess variances in children's growth pattern. This study is aimed at explaining effect of the respondents' sociodemographic characteristics on under-5 children's birth weight and identifying most suitable models, out of 11 statistical models reviewed, for estimating children's growth in terms of height and weight of a given birth-weight category and obtain estimated growth curves. Material and Methods: The study used National Family Health Survey (NFHS)-4 data from four Eastern States of India, consisting of 54,075 under-5 children. Estimated growth curves were obtained, using best-fit models. Results: Birth weight was found to be associated with children's age, gender, birth order, body mass index, mother's education, living place and wealth index. Two models – Cubic Model and Power Model – showed best fit to the height and weight measurements. We obtained estimated growth curves of boys and girls for a given birth-weight category. Conclusions: All socio-demographic factors studied, except respondent's occupation, were associated with children's birth weight. Cubic and Power Models were most suitable for assessing growth in terms of height and weight of boys and girls, belonging to a given birth-weight category. [ABSTRACT FROM AUTHOR]

Context: The American Academy of Pediatrics had recommended that children younger than 2 years should avoid digital media. However, in the Indian context, it was less explored. Aims: The study aimed to determine the relationship between touch screen device (TSD) usage and sleep of infants, toddlers. Methodology: Using a cross-sectional design, 76 parents of infants and toddlers attending well-baby clinic of a tertiary care hospital in Eastern India were approached, and 57 parents who fulfilled the eligibility criteria were selected using a nonprobability convenient sampling technique. Data were collected using a pretested validated tool including TSD usage pattern, the brief infant sleep questionnaire. Descriptive statistics and Pearson correlation were used to analyze the data. Results: The mean age of TSD usage was 15.6 ± 5.8 months with a mean duration of 65 ± 9.6 min/day. Mothers (51%) reported circumstances to offer TSD was feeding the child. There was a significant negative relationship between night sleep and TSD usage among children (r = −0.35, P < 0.01). Conclusions: TSD usage time significantly affects the nighttime duration of sleep of infants and toddlers. Parents to be educated on proper usage and ill effects of TSD to prevent sleep issues. [ABSTRACT FROM AUTHOR]

Background: Nutritional rehabilitation centers (NRCs) were established with the objective of providing institutional care to malnourished children and building the capacity of the primary caregivers of these children. Objectives and Methodology: The objective of this study was to assess the effect of nutritional interventional measures undertaken at NRCs in improving the nutritional status of admitted children; a retrospective facility-based descriptive study was conducted using the monthly performance reports (March 2015 to November 2019) of all NRCs in Dhamtari district, Chhattisgarh. Results: Of the 3171 children registered in the NRCs, the majority were 1--3 years of age (59.22%), female children (55.50%), and from Other Backward Class caste category (56.79%). The district records a cure rate of 56.12%, death rate of 0.03%, and defaulter rate of 4.71%, with an average length of stay being 16.5 days. NRCs of Dhamtari district had less than acceptable level of recovery/cure rate though death rate and defaulter rate were within acceptable standards. Conclusion: Lower cure rate along with lower defaulter rate and death rate with more than recommended length of stay reflects the below-average performance of the NRCs in the district. [ABSTRACT FROM AUTHOR]

Aim: The aim of our study was to study and compare the impact and efficacy of medical nutrition therapy (MNT) with that of the standard nutrition therapy(SNT) in children diagnosed with Severe thiness in the age group of 5-10 years and diagnosed as severely thin. Study Design: It was a prospective comparative study, conducted over a period of 18 months at the Nutrition Rehabilitation, Research and Training Centre (NRRTC) associated with a tertiary care hospital in India. Methods and Materials: A total of 113 children in the age group of 5 to 10 years with severe thinness were enrolled and divided into 2 groups-58 were placed in the MNT group and 55 in the SNT group for a period of 8 weeks. The children in both groups received MNT and SNT diet over the said period of 8 weeks. Primary outcome variables were weight gain and body mass index (BMI) (i.e., change in nutritional status). Results: At the end of 8 weeks, the rate of weight gain (gm/ kg/day) was significantly greater in the MNT group, that is, 2.35 gm/kg/day as compared with the SNT group, that is, 0.73 gm/kg/day, and the change in nutritional status was significantly better in the MNT group (p < 0.001) with 62.1% achieving normal nutritional status, 32.8% remaining thin, and 5.2% remaining severely thin as compared to the SNT group in which 9.1% achieved normal nutritional status, 65.5% remained thin, and 25.5% remained severely thin. Conclusion: To conclude, MNT is superior to SNT for the treatment of severe thinness (ST). [ABSTRACT FROM AUTHOR]

Context: Childhood injuries are a less explored area of public health. In the presence of public health problems such as communicable and noncommunicable diseases, childhood injury has gained less attention from the health system. Aims: The aim of the study was to assess the prevalence of various types of unintentional injuries (UI) amongst children and to assess the factors associated with same. Settings and Design: The study was conducted at Ahmedabad District of Gujarat State, and this is a cross-sectional sStudy. Subjects and Methods: The current study was a part of a multicentric national level research supported by Indian Council of Medical Research. Total 11 sites were selected across India, which all followed a uniform methodology. One of the selected sites was Dholka taluka of Ahmedabad district, Gujarat. This cross-sectional study was conducted in 2341 households. The study participants were children aged from 6 months up to 18 years. A total of 3018 children and their caretakers were interviewed using software-based questionnaire. Statistical Analysis Used: Statistical analysis was performed by frequencies and Percentage, Chi-square Test, Z-Test. Results: The overall prevalence of injuries was 7.62%. Gender and area of residence were significantly associated with UI. Fall-related injuries had the highest prevalence (3.38%), followed by road traffic injuries (RTI) (1.62%). The prevalence of burn-related injuries and poisoning was higher among females compared to males. No mortality was observed due to UI. Conclusions: Majority of the injuries were of minor or trivial type. Fall-related injury and RTI were the most common types of UIs among children. [ABSTRACT FROM AUTHOR]

Background: Despite concentrated global efforts to bring about reduction in malnutrition among children, it continues to remain a public health concern, especially in developing countries such as India. While substantial reduction in the levels of stunting has taken place over the years, high levels of variation exist in distribution of stunting across the country. Objective: The study aimed to identify the determinants of stunting in early childhood and their contribution to change in levels of stunting across India. It also compared the socioeconomic disparity in the levels of stunting and changes therein over the last decade. Methods: The study utilizes data from the National Family Health Survey (NFHS-3 and NFHS-4) on children aged under-2 years. Bivariate and multivariate logistic regression identified determinants of early childhood stunting followed by Oaxaca decomposition model to assess the contribution of each of the factors to reduction in levels of stunting over the years. Concentration index was used to study the socioeconomic disparity in early childhood stunting. Results: Nearly 19% decrease in early childhood stunting can be attributed to increase in institutional deliveries, 14% to increase in maternal schooling, and 10% to improvement in maternal body mass index. In spite of an overall decrease, very little change is seen in socioeconomic disparity of childhood stunting. Conclusions: The study identifies institutional deliveries, maternal schooling, and maternal health as major contributors of decrease in early childhood stunting. It identifies persisting socioeconomic disparity in childhood stunting over the last decade. [ABSTRACT FROM AUTHOR]

Background: Lack of recent local data regarding Vitamin A deficiency, dietary intake, and coverage of biannual high-dose Vitamin A prophylaxis among marginalized children poses challenges for policy change. Objective: Our study aimed to evaluate the burden of serum Vitamin A deficiency, dietary Vitamin A intake, and current Vitamin A supplementation coverage. Methodology: We enrolled 216 children aged 6-60 months from 30 Anganwadis of Chandigarh using two-stage cluster sampling. Results: Dietary intake of Vitamin A-rich foods and vegetables in the last 24 h was observed only in 20% of enrolled children. Although 79.21% (160/202) of children aged ≥9 months reported receiving Vitamin A supplementation, only 38.52% had documented record of age-appropriate complete supplementation. None of the children showed ocular manifestations of Vitamin A deficiency. For the subjects in which C-reactive protein levels were ≤5 mg/l (n = 148), 35.14% (52/148) had serum retinol ≤0.7 µmol/L and 2.03% (3/148) had serum retinol ≤0.3 µmol/L. The multivariate odds ratios (ORs) of Vitamin A deficiency (serum retinol <0.7) were 2.23 times higher in subjects with inappropriate complementary feeding (OR: 2.23; 95% confidence interval [CI]: 1.07-4.80; P = 0.035) whereas odds were significantly lower for middle (OR: 0.27; 95% CI: 0.09-0.76; P = 0.015) and higher income (OR: 0.14; 95% CI: 0.03-0.53; P = 0.005) families in reference to low-income group. Conclusions: Subclinical Vitamin A deficiency is still a public health crisis with suboptimal dietary intake of Vitamin A-rich foods and compromised food diversity necessitating targeted approach for marginalized children. [ABSTRACT FROM AUTHOR]

Context: Availability of antiretroviral therapy (ART) has helped to decrease morbidity and increase the longevity of children living with Human Immunodeficiency Syndrome (CLHIV/CLHA). These children require the special involvement of family members for adherence to care and support programs. Long-term caregiving stress can result in physical, social, emotional, and medical consequences for both the caregiver and the CLHIV. This study explores the burden and needs for support among CLHIV caregivers. Methods: A cross-sectional study was conducted at an ART Centre of Tertiary level Health Care Institute among 126 caregivers of CLHIV pretested and piloted semi-structured questionnaire and Zarit Burden Interview Scale (ZBIS) were employed to assess study objectives. Descriptive statistics and caregiver burden scoring were calculated. ZBIS score of 22 and above were considered additional burden for caregivers. Results: Mean age of caregivers was 34 ± 7.15 years. Among 126 CLHIV caregivers, 116 were female, while 110 had positive HIV serostatus. Ninety-seven percent disclosed their and the child's status to one or more family members. Mean caregiver ZBIS was 25 ± 7.08 with 71.5% caregivers having mild-to-severe levels of burden. Around 85% of caregivers knew correctly about four routes of HIV transmission although 8.7% had misconception regarding HIV transmission. Conclusions: ZBIS assessment shows emotional, financial, and future of child-related burden among CLHIV caregivers. There were gaps in the knowledge about HIV transmission, care and support needs of the CLHIV. The acquisition of HIV from parents in CLHIV suggests the need of strengthening the prevention of parent-to-child transmission program in Indian settings. [ABSTRACT FROM AUTHOR]

Background: Vitamin A deficiency (VAD) and Anemia are important public health nutritional problems in India. Objective: To assess nutritional status and prevalence and correlates of undernutrition, anemia, and VAD among children. Materials and Methods: A community-based cross-sectional study was carried out adopting systematic random sampling. Information on socio-demographic particulars was collected and 20 µL blood was collected for hemoglobin and free-flowing drop on Whatman filter paper for Vitamin A estimation. Hemoglobin was estimated using indirect cyanmethemoglobin and Vitamin A by high-pressure liquid chromatography. Nutritional status was assessed using the WHO Child Growth Standard. Results: The overall prevalence of anemia and VAD was 68% and 59%, respectively, while underweight, stunting, and wasting was 30%, 55%, and 11%, respectively, among under 5 year children. Stepwise logistic regression analysis revealed no significant association of anemia and VAD with any sociodemographic variables, while the odd of stunting was four times higher among children of mothers engaged in labor and two times among children from low-income group, while underweight was two times higher among children from households not having sanitary latrine. Exclusive breastfeeding was observed to be associated with undernutrition among infants. Conclusions: Anemia, VAD, and stunting were high among children. Low intakes of green leafy vegetables and milk and milk product may be the reasons for the higher prevalence of anemia and VAD. There is a need to strengthen supplementation of iron and folic acid tablets and Vitamin A and also public distribution system. [ABSTRACT FROM AUTHOR]

Background: Childhood injury has been recognized as a major threat to child survival and health, as well as economic burden, which includes the cost to government and out-of-pocket expenses (OOPE) to families. Child-To-Child Approach is an innovative technique to reduce childhood injuries and expenses on their treatment. Objectives: To assess economic benefit in the treatment of unintentional childhood injuries, including OOPE by families, by the implementation of the child-To-Child approach. Materials and Methods: The present study is part of a quasi-experimental before-and-after intervention study conducted in the rural area of Delhi for the prevention of childhood injuries through intervention by the child-To-Child approach. Cost of injury treatment, including travel and accommodation expenses, and wage loss were noted. The projected gain in the total cost and out-of-pocket expenditure on injury treatment throughout 20 years of childhood and adolescence were calculated. Results: Both incidences of injuries and total expenditure for treatment of injuries had decreased during the postintervention period in the intervention group, against a rise in the control group. The proportion of OOPE for availing private health care facilities for treatment of injuries, which was more than one-fourth of total expenses, also had decreased in the intervention group during the postintervention period. On economic analysis, it is projected that there will be enormous gain in cost by the implementation of child-To-Child approach in the study area in 20 years, along with saving of OOPE of the families. Conclusion: Child-To-Child approach is effective in preventing childhood injuries and reducing the cost of treatment of injuries. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to know type of hypertension affecting pregnant women and impact on perinatal outcome. Subject and Methods: This is a prospective cohort study; 120 women with hypertensive disorders of pregnancy (HDP) at gestation ≥28 weeks who delivered in our institute were enrolled. Sociodemography, gestational age, mode of delivery, APGAR, birth weight, fetal growth restriction (FGR), and perinatal outcome were recorded. Mean ± standard deviation or proportions, analysis of variance, Chi-square test, and odds ratio were used for statistical analysis. Results: Preeclampsia (PE) was most prevalent hypertensive disorder of pregnancy (44.2%), followed by eclampsia (27.50%), gestational hypertension (23.3%), and chronic hypertension (CH) (5.0%). In PE group, 61.8% had FGR, 65.5% newborns were preterm, 74.6% had low birth weight, and 54.1% needed neonatal intensive care unit (NICU) admission. In eclampsia group, 42.9% had fetal growth restriction, 65.7% preterm, 80% low birth weight, and 78.6% NICU admission. PE women delivered more fetal growth-restricted babies with odd ratio of 2.37 (95% confidence interval [CI]: 1.15, 4.9) and at lower gestation with odd ratio of 2.00 (95% CI: 0.95, 4.21). Eclampsia group had more newborn with low APGAR 1 min, NICU admissions, and those requiring ventilator with odds ratio of 3.10 (95% CI: 1.37, 7.03), 4.48 (95% CI: 1.64, 12.24), and 4.09 (95% CI: 1.6, 10.46), respectively. Perinatal mortality was 10, 9, and 2 in eclampsia, PE, and gestational hypertension groups, respectively, with overall rate of 16.9%. PE and eclampsia comprised 71.70% of HDP but contributed 90.5% of all perinatal deaths. Conclusion: Preeclampsia-eclampsia is associated with increased risk of adverse perinatal outcomes as compared to gestational and CH, necessitating screening, vigilant antenatal care, timely intervention, and referral. [ABSTRACT FROM AUTHOR]