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Background: Early childhood home environment is intricately linked to child development and later cognitive and academic skills. There is limited literature evaluating home environmental trends and predictors in the low‐ and middle‐income country settings. Aims: Determine the trends of early childhood home environment changes between 6 and 36 months of age, and the factors associated with these changes. Study design Longitudinal community‐based birth cohort follow‐up study in a semi‐urban slum in Vellore, South India. Subjects: Consecutive sampling of a birth cohort between March 2010 and February 2012. Outcome measures Home environment was objectively assessed using the 'Home Observation for the Measurement of the Environment' (HOME) scale. Predictors of change in the home environment over time also were analyzed. Multivariable linear regression models and linear mixed effect models were used to identify the factors associated with HOME score at individual time points and over‐a‐time period, respectively. Results: The birth cohort enrolled 251 children with a follow‐up of 235, 228 and 218 children at 6, 24 and 36 months, respectively. The socio‐economic status (SES) was the single biggest predictor for the HOME score at each time point, with increasing strength over time. Maternal education predicted home environment at 24 months, while maternal depression was negatively associated at 6 and 24 months of age. SES and maternal factors contributed to the overall change in the HOME score. Maternal factors predicted relational home environmental change over time. Conclusion: SES and maternal factors consistently predicted early childhood home environment at 6, 24 and 36 months of age and its change over time. It is important to support maternal education and wellbeing along with socio‐economic measures to optimize early childhood environment. [ABSTRACT FROM AUTHOR]

The article presents the authors' views on the need of a paradigm shift for control of tuberculosis (TB) in high prevalence countries. According to the authors, emphasis should be given on providing health education in schools and in the community and lessons on cough etiquette, spitting behavior etc. The authors suggest application of microbiology for diagnosis, drug sensitivity monitoring and community education for TB control.