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Background: High proportion of multibacillary (MB) among newly diagnosed leprosy cases poses a public health challenge., Objectives: This study aimed to find out the factors associated with the high burden of MB leprosy in West Bengal., Materials and Methods: This case-control study was conducted from August 2020 to December 2022 in three high-endemic districts (annual new case detection rate ≥10/lakh) of West Bengal., Objectives: MB cases registered under the National Leprosy Eradication Programme were considered as case and paucibacillary (PB) cases were considered as control. Weighted sample sizes for cases and controls in each of the three districts were selected using simple random sampling from the list of registered leprosy patients. Requisite data were collected through structured interview with a validated questionnaire in Bengali. R, version 4.1.1 (R Foundation for Statistical Computing, 2021, Vienna, Austria) was used for data analysis. A binary logistic regression model was prepared with the type of leprosy as a dependent variable., Results: Three hundred and ninety-eight individuals, 204 MB and 194 PB, participated in this study with 1.97% nonresponse rate. Gender, marital status, and diagnostic delay (adjusted odds ratio = 2.75 [1.66,4.65]) were associated with developing MB. Not perceiving the symptoms seriously (90, 56% [PB], 97, 51% [MB]), lack of knowledge about the disease and its complications (47, 29% [PB], 53, 28% [MB]), delayed referral by the private practitioners (11, 7% [PB], 22, 12% [MB]) were the major reasons of delay., Conclusion: This study identified a vulnerable group - married and migrated males. Changing from annual screening to quarterly screening along with capacity building and awareness generation of the targeted population is the need of the hour for eradicating the disease., (Copyright © 2024 Copyright: © 2024 Indian Journal of Public Health.)

Background: Research on different measures of food security and their interrelation in order to identify vulnerable households are scarce in India., Objectives: The objective was to assess household food security (HHFS), nutrient adequacy, dietary diversity, and nutritional status of under-five children along with their interrelation in the slums of Bankura Municipality, West Bengal., Methods: A cross-sectional study was conducted during 2016-2017 among 240 households using two-stage 30-cluster random sampling. Information regarding socioeconomic characteristics, availability, and utilization of different poverty alleviation schemes was collected. HHFS was assessed by a validated HHFS scale-short form in Bengali and nutrient adequacy with 24-h recall method. The eldest under-five child in the family was measured for anthropometry using standard procedure and for dietary diversity with the Individual Dietary Diversity Score., Results: Overall, 74 (29.1%) households had "food security," whereas 102 (44.3%) and 64 (26.6%) had, respectively, low and very low food security. Among 190 under-five children, 63 (35.3%) had single and 50 (25.5%) had multiple anthropometric failures. Overall, 89 (36.1%) households were deficient for both energy and protein and 111 (47.6%) had deficiency of either of these two. Indicators on the utilization of different poverty alleviation schemes were associated with low/very low food security. A "Composite Index of Food Scarcity" comprising of HHFS, nutrient adequacy, and dietary diversity was proposed which was found to have dose-response relationship with grades of anthropometric failure of under-five children., Conclusions: An index comprising of three indicators might help identify the vulnerable households in relation to food security more effectively than a single indicator., Competing Interests: None

Background: Stigma among caregivers of people with mental illness has a serious impact on the disease outcome and lives of people with mental illness as well as other family members., Objectives: The objectives of this study were (i) To determine the level of self-perceived stigma toward mental illness, (ii) To measure perception to it among caregivers of people with mental illness, and (iii) To identify the factors associated with self-perceived stigma of caregivers., Methods: In this cross-sectional study, a structured interview was conducted among 200 caregivers of people with mental illness in the psychiatry outpatient department of a tertiary care hospital in West Bengal, India. Stigma and perception regarding mental illness were assessed with a validated 12-item Explanatory Model Interview Catalogue and 20-item perception scale, respectively. Information on their sociodemographic characteristics was also collected., Results: Average stigma score (53.3 ± 13.2) was higher than 50% of maximum attainable score. Caregivers of higher age, female gender, low income, higher education, manual job, rural residence, and those who are single or widowed scored higher in stigma scale. Caregivers with female gender (P = 0.007) and rural residence (P = 0.01) were more likely to have stigma while the perception score was negatively associated (P < 0.001) with stigma score., Conclusion: The study highlighted that health-care providers can play a pivotal role to address caregivers' stigma in order to alleviate its effect on the course of illness and improve family life., Competing Interests: There are no conflicts of interest.

Background: Early diagnosis and effective treatment are the key areas in malaria control in India., Objective: The present study was carried out to assess the knowledge and skill of health personnel at primary care level and the logistic support related to the program at subcenter (SC) level., Methods: A cross-sectional, descriptive study was conducted among medical and paramedical personnel working at primary health-care institutions in two districts of West Bengal. Knowledge was assessed using a structured questionnaire while diagnostic skill and logistic support were assessed with structured checklists. Clinical skill was assessed with case vignettes., Results: Requisite knowledge on diagnostic procedure was found in two-third to three-fourth of health personnel while only 26.7% and 12.4%, respectively, knew the correct treatment of Plasmodium vivax and Plasmodium falciparum malaria. Median standardized score for knowledge was 50.0 while the scores for skill of preparing blood slide and for rapid diagnostic test were 70.0 and 57.1, respectively. Education and work experience were related to diagnostic skill but had little effect on knowledge. In clinical skill, medical personnel scored 50% or more in investigation and treatment aspects only. In another case vignette, health workers excelled over medical officers and other staff in all axes other than history taking and clinical examination although their performance was also suboptimal. Formal training on malaria did not show any bearing on median knowledge and skill score. Supply of diagnostics and drugs was insufficient in majority of SCs., Conclusion: Renewed efforts are needed to create competent workforce and ensure adequate logistic supply.

Background: Birth preparedness and complication readiness (BPCR) is the process of planning for normal birth and anticipating the actions needed in case of an emergency which is critical in averting maternal morbidity and mortality., Objectives: To find out awareness and practices regarding BPCR among pregnant and recently delivered women in Bankura, West Bengal., Materials and Methods: A cross-sectional, community-based study was carried out among 120 pregnant women and 235 recently delivered women. Information on sociodemographic variables as well as awareness and practices regarding BPCR were collected through semi-structured interview. For statistical analysis Z-test was used., Results: The majority of respondents (69.3%) had registered for antenatal care within the first 12 weeks of their pregnancy and 74.0% of the recently delivered women had four or more antenatal check-ups and 81.3% had institutional delivery. The BPCR index of pregnant women and recently delivered women was 45.2 and 59.0, respectively, whereas BPCR index of the total was 52.1., Conclusion: Although the BPCR indicators are satisfying, the health system should use the opportunity during visits to health institutions to increase awareness among the pregnant women and her family on how to plan for the pregnancy and identify danger signs.

Introduction: Nutrient adequacy is the level of intake of an essential nutrient in relation to the nutrient requirement for adequate health, which is expressed as the percentage of recommended dietary allowance. To develop an effective nationwide preventive program to combat malnutrition, it is necessary not only to assess the nature and magnitude of the problem of nutrient inadequacy but to identify factors affecting it especially at the household level., Objective: To estimate the prevalence of nutrient adequacy in a sample of households in a rural area of Darjeeling district and to find out the factors associated with nutrient adequacy., Materials and Methods: A community-based cross-sectional study was carried out from January 2014 to December 2014 in 821 households of Darjeeling district, India. The major dependent variable used in this study was the mean nutrient adequacy ratio of a household and the independent variables were number of family members, number of under-five children in the family, literacy of head of the family, literacy of the wife of the head of the family, income of the family, and percentage expenditure on food., Results: The prevalence of nutrient adequate households was found to be 35.3% among the study households. It was observed that the percentage expenditure on food had the highest contribution toward nutrient adequacy, followed by number of under-five children in the family and literacy of the wife of the head of the family. Undernutrition was found to be prevalent in 56.6% of the households., Conclusion: Majority of the study population had a diet less than the required amount and expectedly, undernutrition was also present in huge proportions.

Background: Janani Shishu Suraksha Karyakram (JSSK) was launched in India to ensure cost-free institutional delivery., Objectives: 1) To assess the awareness of recently delivered women regarding JSSK 2) To estimate the cost of institutional delivery and its differentials., Materials and Methods: A community-based, cross-sectional study was conducted in a rural community in Bankura, West Bengal, India in 2013, among 210 women who delivered babies in the last 12 months. Information regarding sociodemographic and health service-related variables as well as item-wise costs incurred for institutional delivery were collected. Costs were expressed in Indian National Rupee (INR). A nonparametric, bivariate analysis was performed to examine the difference in median cost., Results: All components of JSSK were known to 12.9% women; the highest (77.1%) for admission and lowest (29.0%) for blood transfusion. The median (±IQR) costs of delivery in the Block level Primary Health Center (PHC), medical college, and private facilities were INR 205.0 (±825.0), 900.0 (±1013.0), and 6600.0 (±16195.0), respectively. Median cost of normal delivery in a private facility (INR 2750.0) was 3.6 times of that in a government facility (INR 765.0). Median direct cost of caesarian section (CS) in a government facility (INR 1100.0) was nearly one-fifteenth of that in a private facility (INR 16,350.0). Cash incentives under Janani Suraksha Yojana for poor and socially marginalized women could not cover the cost of CS delivery in a government facility., Conclusion: Gaps existed in the awareness of beneficiaries regarding entitlement under JSSK. Drugs and transport were two major causes of out-of-pocket (OOP) expenditure in public health facilities.

Context: Birth Preparedness and Complication Readiness (BPCR) is crucial in averting maternal morbidity and mortality., Objectives: To find out awareness and practices regarding BPCR among pregnant and recently delivered women in Uttar Dinajpur, West Bengal., Materials and Methods: This is a cross-sectional, community-based, mixed methods study. Two-stage, 40 cluster sampling technique was used to select three pregnant and six recently delivered women separately. Information on socio-demographic variables as well as awareness and practices regarding BPCR were collected through semi-structured interview. In-depth interviews with one respondent per cluster were also conducted. For statistical analysis Z test was used., Results: Around 50% of the respondents planned for first antenatal check-up (ANC) within 12 weeks, four or more ANCs and institutional delivery. Proportion of women aware of at least one key danger sign each of pregnancy, labor, postpartum, and newborn ranged from 12.1% to 37.2%, whereas 58.3% knew at least one key component of essential newborn care. Around two-thirds and one-third of women, respectively, especially those from backward and below poverty line (BPL) families knew about cash incentive and referral transport schemes. Proportions of women with first ANC within 12 weeks, four or more ANCs, institutional delivery, saving money, identifying transport, and blood donor were 50.4%, 33.6%, 46.2%, 40.8%, 27.3%, and 9.6%, respectively. Hindu religion, backward castes, BPL status, and education ≥ 5 years influenced the practices except for two regarding ANC. Overall BPCR index of the study population was 34.5., Conclusion: Preparedness in health system, ensuring competence, and motivation of workers are needed for promoting BPCR among the study population.

A cross-sectional study was conducted among police personnel (N = 1817) in Bankura District, West Bengal, India to estimate the prevalence of diabetes mellitus (DM), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and its correlates during July-November, 2011. Participants were enquired about their age, gender, physical activity, and predominant occupational activity. Diagnosis of DM, IFG, and IGT was based on a history, fasting, and 2-h post-load blood glucose estimation as per World Health Organization (WHO) criteria. Body mass index, waist circumference (WC), and blood pressure (BP) were estimated. Out of 1817 subjects, DM was found in 15%, 1.1% had IFG and 5.7% had IGT. Age >50 years, family history of diabetes, hypertension, and abdominal obesity were found to be significantly associated with DM and IGT, whereas IFG was significantly associated with the family history of diabetes and hypertension. High prevalence of diabetes and pre-diabetic condition warrants early effective intervention to keep the police force healthy and agile.

'Janani Suraksha Yojana (JSY)' was implemented in India to promote institutional deliveries among the poorer section of the society. A cross-sectional study was conducted in Bankura district among 324 women who delivered in last 12 months selected through 40 cluster technique to find out institutional delivery rate, utilization of JSY during antenatal period and relation between cash benefit under JSY during antenatal period and institutional delivery. Overall institutional delivery rate was 73.1% and utilization of JSY among eligible women was 50.5%. Institutional delivery (84.0%), consumption of 100 iron-folic acid tablets (46.0%) and three or more antenatal check-ups (91.0%) were better in women who received financial assistance from JSY during antenatal period than other women. After adjustment for socio-demographic factors, JSY utilization came out to be significantly (P=0.031) associated with institutional deliveries. The study showed that cash incentive under JSY in antenatal period had positive association on institutional deliveries.

Background: Strengthening food security enhancement intervention should be based on the assessment of household food security and its correlates., Objectives: The objective was to find out the prevalence and factors contributing to household food security in a tribal population in Bankura., Methods: A cross-sectional study was conducted among 267 tribal households in Bankura-I CD Block selected through cluster random sampling. Household food security was assessed using a validated Bengali version of Household Food Security Scale-Short Form along with the collection of information regarding the monthly per capita expenditure (MPCE), total to earning member ratio, BPL card holding, utilization of the public distribution system (PDS) and receipt of any social assistance through a house-to-house survey., Result and Conclusion: Overall, 47.2% of study households were food secure whereas 29.6% and 23.2% were low and very low food secure, respectively. MPCE ≥ Rs. 356, total to earning member ratio ≤ 4:1, regular utilization of PDS, and nonholding of the BPL card were significantly related with household food security.

A cross-sectional, community based study was undertaken in Patpur slum of Bankura to determine the prevalence of chest symptomatics, their health care seeking Behavior and its correlates. Prevalence of chest symptomatics (cough for 3 weeks or more) was found to be 5.5%, three fourths of whom sought relief from a health care provider. Among them, 70.8% did so within 2 weeks, median being 7 days. No preference for either government or private health care provider was seen in first visit, where the major reason for choosing facilities was advice by family & friends (43.8%). Most of the chest symptomatics (75%) were retained in the same facility. Shift from private to government facility for subsequent visits (33.3%) was higher than from government to private facility (16.7%). The main reason (50%) for changing health facility was expectation for better service.