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Background: Regular physical activity is an important behavior for promoting health or preventing diseases. Poor participation in physical activity, especially in school-going children, has a multifactorial causation. Present study aimed to find out the proportion and determinants of insufficient physical activity among school-going adolescents at selected government high schools of Dumdum. Methodology: A cross-sectional observational study was conducted among school-going adolescent students of class VIII, IX, X, XI, XII in two selected government high schools of Dumdum municipality of North 24 Parganas. Complete enumeration method was used to select 199 participants. Students, who were absent during the day of the survey or were not willing to participate were excluded. A pre-designed pretested structured schedule was used to collect data. Data was analyzed using statistical software SPSS version 16. Results: Out of 199 students, 62.9% were aged 13--14 years with mean age 14.4 (±1.37). 54.3% were females. Only 22.1% do adequate physical activity, 59.8% participants have satisfactory attitude towards adequate physical activity practices. 42.2% participants were addicted to smartphone according to smartphone addiction scale (SAS). Physical activity was significantly associated with female gender (OR = 2.56. 95% CI = 1.28--5.11), unsatisfactory attitude (OR = 2.41, 95% CI = 1.13--5.10) towards PA practices, high smartphone addiction (OR = 2.57. 95% CI = 1.23--5.35), and more screen time (OR = 2.20, 95% CI = 1.11--4.37). Conclusions: Physical activities in the school environment have short-term as well as long-term benefits over health. Various factors act as a barrier to physical activity. PA promotion programs in the school setting is needed for disease-free and healthy life. [ABSTRACT FROM AUTHOR]

Background: Use of maternal near-miss (MNM) cases as an adjunct has been advocated to understand the processes of obstetric care because they share similar pathways as maternal deaths. Identifying the predictors and care pathway is crucial to improve the quality of care and end preventable maternal deaths. Materials and Methods: This case–control study was conducted at a tertiary care facility in Kolkata from May 2019 to March 2020. Women admitted with complications during pregnancy, childbirth, or within 42 days of postpartum, who met the World Health Organization (WHO) near-miss criteria, were identified as cases, and equivalent age-group matched controls were recruited. Sample size of 60 cases and 60 controls was estimated, assuming a power of 80%, level of significance 0.05, and case–control ratio of 1. After obtaining approval from the institutional ethics committee and informed written consent from the participants, data was collected through face-to-face interview and review of records. Statistical analysis including care pathway analysis (using three-delay model) was performed using Statistical Package for Social Sciences version 16. Results: Joint family type (adjusted odds ratio [AOR] [CI] = 5.06 [1.48, 7.28]), lack of antenatal checkups (AOR [CI] = 7.85 [1.47, 12.09]), previous history of cesarean section (AOR [CI] = 3.94 [1.09, 14.33]), first delay in seeking care (AOR [CI] = 13.84 [3.62, 32.83]), and preexisting medical disorders (AOR [CI] = 11.03 [4.62, 22.80]) were identified as significant predictors of MNM in the adjusted model. Significant difference in the proportion of first and second delays in the care pathway was observed between cases and controls. Conclusions: Identification of risk factors of MNM and pattern of delays in the care pathway will help improving quality of obstetric care. [ABSTRACT FROM AUTHOR]

Background: Infertility, which is an inability to conceive after a prolonged time period, is a neglected domain of reproductive health. Infertility affects couples physically and psychologically and leads to discrimination and stigma in society, especially to women. Various sociodemographic, physiological, and environmental attributes and access to health care may interplay with the quality of life (QoL) of the women afflicted with infertility. Objectives: The aim of this study was to assess the QoL and its predictors among women diagnosed with infertility. Materials and Methods: A cross‑sectional study was conducted among 247 women diagnosed with infertility and receiving treatment for at least 6 months at a gynecology outpatient department in a tertiary care hospital of Kolkata. Results: The mean (±standard deviation) score of total ferti‑QoL was 65.76 (±11.15). Differential mean scores were observed in domains of ferti‑QoL such as emotional (58.49 ± 12.75), body/mind (47.67 ± 16.14), relational (78.36 ± 15.51), social (60.71 ± 12.43), core (61.31 ± 12.71), environment (80.09 ± 10.77), tolerability (70.95 ± 11.97), and treatment (76.44 ± 10.36). Nearly half of them also reported abuse in terms of verbal (50.6%) and physical (6.9%). On multivariable analysis, unsatisfactory QoL was significantly associated with age above 32 years (adjusted odds ratio [AOR] = 2.76, confidence interval [CI] = 1.07–7.12), increasing duration of infertility (AOR = 1.46, CI = 1.17–1.82), and presence of chronic diseases (AOR = 2.21, CI = 1.01–4.83). Conclusion: There is, till date, no provision of management for women suffering from infertility in the Reproductive and Child Health Programme. The problem of infertility must be considered as a public health problem, and all policymakers, health administrators, and other stakeholders should come forward with exemplary guidelines specially targeted for providing relief to these affected women in every stratum of the health‑care system. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is still a great barrier to the growth and development of children, especially in India. Children from the underprivileged sections of the society like slum children are more vulnerable to both undernutrition and overnutrition. This study aimed to estimate the magnitude of malnutrition among school-going children in a slum area of Kolkata and to elicit the association of nutritional status with parental education. Methods: A cross-sectional observational study was conducted from November 2017 to May 2018 among 508 school-going children of 6 years to 19 years of age in slums of Chetla, Kolkata. Out of three coeducation high schools catering to those children, two schools were randomly selected. 254 participants from each school were selected using systematic random sampling. Students, unwilling to participate and/or whose parents denied providing informed written consent were excluded. After the interview by a predesigned, pretested schedule, their anthropometric examination was conducted. Results: Prevalence of stunting and severe stunting was present in 9.4% and 1.2% of subjects whereas the prevalence of thinness was 23.6% among them. The prevalence of overnutrition was 11%. Boys are more stunted (OR = 2.13, P = 0.013) and thin (OR = 1.73, P = 0.011) than girls. Poor parental education was significantly associated with both undernourishment (stunting and thinness) as well as overweight and obesity. Conclusion: Substantial burden of double malnutrition was observed among school-going slum children. Parental education had an important role to prevent malnutrition of their children. Thus, periodic growth monitoring with the strengthening of the Mid-Day Meal program and awareness generation campaigns regarding malnutrition among parents of slum children are highly needed. [ABSTRACT FROM AUTHOR]

Context: Tobacco smoking is one of the preventable causes of death. Global Adult Tobacco Survey 2 report showed that 19% Indian males were current smokers. It is important to find out factors which help smokers on smoking cessation, ultimately to prevent of lung and other morbidities. There are few community-based studies on intention and attempt to quit smoking in rural area. Aims: The present study aimed to determine the factors associated with intention and attempt to quit smoking among current smokers. Settings and Design: A cross-sectional study was conducted from June to September 2019 among 198 male daily smokers residing in the rural field practice area of AllH and PH, Kolkata. Subjects and Methods: After cluster sampling, data were collected by predesigned schedule by the face-to-face interview. Results: 151 (76.3%) study subjects intended to quit smoking. 63 (31.8%) study subjects attempted to quit in last 1 year. Thirty-one (47.5%) showed high-to-medium nicotine dependence. There was a significant association of intention to quit with agriculture as occupation (acquisitive crime [AOR]-2.17, confidence interval [CI]-1.01--4.63), low nicotine dependence (AOR-2.98, CI-1.43--6.21), doctor's advice (AOR = 2.84, CI-1.27--6.33), and family pressure (AOR = 2.16, CI-1.07--4.38). Attempt to quit was significantly associated with low nicotine dependence (AOR = 5.85, CI-2.85--12.00), family pressure (AOR = 2.94, CI-1.47--5.91). Conclusion: Along with counseling to reduce nicotine dependence, comprehensive approach both from family members as well as health care providers, is vital to escalate the quitting behaviour in smoking habit. [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]

Context: In India, despite implementation of the strategies under National Tobacco Control Programme [NTCP], women are easily exposed to tobacco consumption that is smokeless (SLT) and smoking tobacco along with second-hand smoke [SHS], making them highly susceptible to tobacco hazards. Aims: This study aimed to assess the exposure of women to tobacco use and SHS at home and to elicit predictors of tobacco exposure in a rural community of West Bengal. Methodology: A community based, cross-sectional study was conducted among 176 women aged 18 years and above. Data was collected by cluster sampling technique (16*11) using predesigned pretested structured schedule. Tobacco exposure was measured using a composite score including tobacco consumption and SHS at home. Results: Tobacco use (SLT and smoking tobacco) was significantly associated with educational attainment [AOR = 2.12], occupation [AOR = 2.13] and knowledge [AOR = 1.22]. There was significant association between SHS at home with knowledge [AOR = 1.16] and attitude of the study subjects. [AOR = 1.93]. Overall tobacco exposure (SLT, smoking tobacco, and SHS), was found to be 79.5%. Significant association was found between high tobacco exposure with age group [AOR = 3.82], educational attainment [AOR = 1.74] and knowledge regarding hazards of tobacco [AOR = 1.31]. Conclusion: Prevalence of SLT use as well as exposure of women to SHS at home is unexpectedly high in the study population. Women specific information and education campaigns focusing on tobacco hazards (both tobacco use and SHS) through existing primary health care infrastructure should be strategized under NTCP. [ABSTRACT FROM AUTHOR]

Background: Dietary preferences and childhood eating behavior has marked influence on nutritional status of children. The objective of the study was to find out eating behavior of primary school children in a rural area of West Bengal using Child Eating Behavior Questionnaire and to determine association of body mass index (BMI) with eating behavior. Methodology: It was an institution-based observational study with cross-sectional design done from May to August, 2018. The study was done among 142 children studying at four primary schools at Singur, in the rural field practice area of our institute. The four schools were selected randomly using list of primary schools in the area. Eating behavior of children was assessed using Child Eating Behavior Questionnaire (CEBQ). BMI of the children was assessed using WHO Z scores tables for children. Data analysis was done using SPSS Version 16 and binary logistic regression was done to find out association of BMI with eating behavior of study participants. Results: The proportion of under-nutrition and overnutrition was 22.0% and 16.0%, respectively. Food fussiness was significantly associated with thinness [BMI below (−2SD)]. Enjoyment of food, satiety response was significantly associated with overnutrition [BMI above (+1 SD)]. Food avoidance subscale was significantly associated with thinness [OR: 2.5, CI: 1.11, 5.63] and this subscale was protective for overweight [OR: 0.22, CI: 0.07, 0.69]. Conclusion: This study showed association of BMI with child eating behavior. Therefore, awareness among parents should be created to change problematic eating of their children which would further help them to achieve normal BMI. [ABSTRACT FROM AUTHOR]

Context: Rice mill workers usually belong to unorganized sector and lack in training regarding hazard prevention. Unprotected exposure to suspended particles and fumes can lead to respiratory morbidities among them. Workers, especially loaders, were susceptible to work‑related musculoskeletal diseases. Aim: To find out the morbidity profile and associated factors among rice mill workers. Methodology: A cross‑sectional workplace‑based study was conducted during July‑‑September 2018 among 143 workers of two rice mills in Indas block, West Bengal. Workers, employed for at least 6 months in the rice mills and who gave informed written consent was interviewed using a predesigned pretested questionnaire and were clinically examined. Nonfasting capillary blood glucose estimation and spirometry were carried out. Workers contraindicated to spirometry were excluded. Result: Commonest morbidities were musculoskeletal discomfort (65%), hypertension (20.9%), and chronic respiratory morbidity (16.9%). No personal protective equipment (PPE) was used by these workers. Significant association of musculoskeletal discomfort was found with tobacco abuse (Adjusted Odds Ratio (AOR) =2.90), job of loader (AOR = 3.51), and central obesity (AOR = 3.39). Hypertension was significantly associated with increasing age (AOR = 1.06), and increasing body mass index (AOR = 1.17). Whereas increasing age (AOR = 1.08), working inside mill (AOR = 7.58), working more than 48 hours a week (AOR = 7.37) were significantly associated with chronic respiratory morbidity. Conclusion: Optimization of working hours, effective continuous use of PPE, and use of proper ventilation technology are recommended. Proper work placement, preplacement examination, and periodic health screening with spirometry are also needed. [ABSTRACT FROM AUTHOR]

Background: On March 27, 2014, the Regional Certification Commission of the World Health Organization certified South-East Asian Region, which includes India, as polio free. Since then, as part of Polio Endgame Strategy, high-quality national and sub-national polio rounds are being conducted to maintain herd immunity through each year. With years of no fresh cases of polio, several sections in the community have raised doubts over the continuation of the Intensified Pulse Polio Immunization (IPPI) program in postcertification era. Thus, this study with mixed method approach was aimed at assessing the community perceptions toward IPPI using quantitative approach and stakeholder's perception using qualitative approach in a high-risk area of Kolkata. Methods: This cross-sectional study was conducted over a period of 2 months from March to April 2018 in Southern part of Kolkata which involved surveying 104 randomly selected households followed by key informant interviews with community influencers. Pearson's Chi-square test was performed to determine the association between categorical variables. SPSS v. 16.0 software was used for analysis. Results: Inadequate knowledge (32%) and unfavorable attitude (45%) regarding IPPI were observed among the interviewed respondents. Safety concern (5.7%), spouse/elderly pressure (4.8%), and sterility issues (1.9%) were identified as prominent barriers resulting in hesitancy (16.2%) during IPPI. Statistically significant association of respondent's attitude was observed between gender, religion, and education. Conclusion: Social behavior change communication involving community and community influencers would help to overcome the barriers to IPPI coverage and thus to mitigate the risk of re-emergence of polio in future. [ABSTRACT FROM AUTHOR]

Context: "Frailty" is a multidimensional geriatric syndrome that increases the risk for adverse health outcomes, such as falls, hospitalization, increased morbidity, and mortality, among elderly persons. Aim: The objective of this study is to find out the proportion of frailty and its associates among elderly (aged ≥60 years) in a rural area of West Bengal. Settings and Design: It is a community-based cross-sectional observational study done during May–August 2018 among 165 elderly persons selected by systematic random sampling by probability proportionate to size method from three villages at the rural field practice area of our institute. Materials and Methods: Tilburg frailty indicator is used to measure frailty. An elderly is considered as frail if s/he scores ≥6 in this scale. Statistical Analysis: Data analysis is done by SPSS Version 16. The logistic regression is done to find out the associates of frailty. Results: Proportion of frailty is 38.8% (mean age ± SD: 67.03 ± 3.43 years) among the study subjects. Age, female gender, loss of spouse, illiteracy, economic dependency, no job/at home status, ≥2 chronic diseases are significantly associated with frailty in univariate logistic regression. In multivariable logistic regression, ≥2 chronic diseases [AOR: 8.4, CI: 4.6, 11.33] and illiteracy [AOR: 3.3, CI: 1.05, 9.8] retain their significance. Conclusion: Frailty should be recognized as a public health priority and awareness generation among elderly population for healthy ageing including self-motivation for proper management of their ailments should be emphasized for reduction of morbidity as well as for augmenting their quality of life. [ABSTRACT FROM AUTHOR]