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Introduction: Falls are an important health problem among elderly, with various consequences. The objectives of this study were to estimate 1-year incidence of falls, distribution, and severity of fall-related injuries and to determine risk factors for fall risk among the elderly population aged =60 years. Methods: A total of 140 urban community-dwelling participants aged =60 years were studied using an investigator-administered questionnaire. Short physical performance battery, chair stand test, handgrip strength, and anthropometric measurements were done. The Chi-square test was done to compare fallers and nonfallers. Logistic regression was done for independently associated risk factors. Results: One-year incidence of falls was 14.3%; 17.6% among women and 9.1% among men. Sixty percent of participants had multiple falls. Seventy-five percent of the fallers were overweight or obese. Sprain was the most common reported fall-related injury (20%), whereas 45% had no injuries. Depression (60%), osteoporosis (80%), poor activities of daily living (90%), and polypharmacy (35%) were significantly associated with falls. Osteoporosis (odds ratio: 14.89; 95% confidence interval: 1.91-115.95) was independently associated with fall risk. Conclusions: The burden of falls among urban elderly was low. The majority of the population experienced multiple falls. Since chronic diseases including osteoporosis and poor mobility were directly associated with the risk of falls, further longitudinal studies may explore the health-related and socioenvironmental risks further. [ABSTRACT FROM AUTHOR]

Objectives: The objective was to determine odds of frailty syndrome with coexistence of hypertension and depression among oldest-old adults. Methods: We analysed secondary data from 167 community-dwelling hypertensive participants aged 80 years and older from a cross-sectional study of frailty conducted in India. Data included sociodemographic, medical history, physical performance, functional limitations, mobility-disability, cognition, depression, sleep, frailty syndrome and chronic diseases. Odds of frailty syndrome was compared among individuals having only hypertension, and individuals having hypertension and depression. Chi-square test, t-test and logistic regression were performed to determine odds of frailty. Results: Frailty was significantly higher (OR:4.93;95%CI:1.89-12.84) among individuals having hypertension and coexisting depression, compared to individuals having only hypertension. Men (OR:5.07;95%CI:1.02-25.17) and women (OR: 4.58;95%CI:1.36-15.40) with hypertension and depression showed a higher risk of frailty, compared with hypertension alone. Logistic regression models were adjusted for age, sex, cognitive impairment, chronic obstructive pulmonary disease, cardiovascular diseases, anaemia, diabetes, obesity, physical performance, activities of daily living and 4-meter walking speed. Conclusion: Coexistence of hypertension and depression increased risk of frailty syndrome among men and women above 80 years of age by almost 5 folds. Treating depression in hypertensive older individuals may reduce the risk of frailty among them. [ABSTRACT FROM AUTHOR]

Introduction: Health assistants are important functionaries of the primary health care system in India. Their role is supervision of field-based services among other things. A quality assurance mechanism for these health assistants is lacking. The present study was undertaken with the objectives of developing a tool to assess the quality of health assistants in primary health centres (PHCs) and to assess their quality using this tool. Methodology: Health assistants from three PHCs in the Wardha district of India were observed for a year using a tool developed from primary health care management Aavancement program modules. Data was collected by direct observation, interview, and review of records for quality of activities. Results: Staff strength of health assistants was 87.5%. None of the health assistants were clear about their job descriptions. A supervisory schedule for providing supportive supervision to auxiliary nurse midwives (ANMs) was absent; most field activities pertaining to maternal and child health received poor focus. Monthly meetings lacked a clear agenda, and comments on quality improvement of services provided by the ANMs were missing. Conclusion: Continuous training with sensitization on quality issues is required to improve the unsatisfactory quality. [ABSTRACT FROM AUTHOR]

Summary Background Dengue surveillance data in India are limited and probably substantially underestimate the burden of disease. A community-based study was undertaken to assess the prevalence of dengue-specific immunoglobulin G (IgG) antibodies in children across India and to examine historical dengue exposure rates. Potential associations between socio-economic factors and dengue seroprevalence were also assessed (registered at ctri.nic.in: CTRI/2011/12/002243). Methods A convenience sample of 2609 healthy children aged 5–10 years was enrolled; these children were registered at or were living in the vicinity of eight centres located at six geographically distinct sites across India. Blood samples were drawn to test for the presence of dengue IgG antibodies using ELISA. Serotype-specific neutralizing antibody titres were measured in dengue IgG-positive children using dengue plaque reduction neutralization tests. Socio-demographic and household information was collected using a questionnaire. Results Overall, 2558/2609 children had viable samples with laboratory results for dengue IgG. Dengue IgG seroprevalence across all sites was 59.6% (95% confidence interval 57.7–61.5%): the lowest (23.2%) was in Kalyani, West Bengal, and the highest (80.1%) was in Mumbai. Seroprevalence increased with age. Multivariate analysis suggested associations with household water storage/supply and type of housing. Half of the subjects with positive IgG results presented a multitypic profile, indicating previous exposure to more than one serotype. Conclusions The overall dengue seroprevalence suggests that dengue endemicity in India is comparable to that in highly endemic countries of Southeast Asia. Additional prospective studies are required to fully quantify the disease burden, in order to support evidence-based policies for dengue prevention and control in India. [ABSTRACT FROM AUTHOR]