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Introduction: In recent times, there is an increase in life expectancy leading to demographic transition toward aging population in both developed and developing countries. Oral health represents a major concern for general health; hence, the oral health of older people is increasingly important. One particularly meaningful factor is the number of teeth which provide information about the functionality of the masticatory system, an esthetic smile as well as an esthetic profile. Losing teeth can be psychologically traumatic, socially damaging, and functionally limiting, thereby affecting the quality of life (QoL). Aim: The aim of this study was to assess the oral health status and factors associated with poor oral health-related QoL in geriatric population (aged >60 years) in rural South India. Materials and Methods: A community-based cross-sectional study was conducted among 437 elderly in Kaniyambadi block of Vellore district. Sociodemographic details were collected directly by face-to-face interview, and the elderly were subjected to oral examination for oral health status. Oral health-related quality of life (OHrQoL) was measured using the Geriatric Oral Health Assessment Index (GOHAI). Factors associated with poor OHrQoL were analyzed using multiple logistic regression. Results: The study population comprised 31.1% (n = 136) of males and 68.9% (n = 301) of females, with a mean age of 68 (standard deviation - 6.9) years. On oral examination, the prevalence of dental caries and any type of edentulism was 51.5% (n = 225) and 82.4% (n = 360), respectively. The prevalence of complete edentulism was 10.1% (n = 44). By assessing oral health-related quality of life using the revised GOHAI tool, 30 (6.9%) had high scores between 34 and 36, 166 (38%) had scores between 31 and 33, and 241 (55.1%) had low scores (=30). In the multivariate analysis, age >70 years (odds ratio [OR] =1.92, 95% confidence interval [CI] = 1.2-3.06, P = 0.006), male gender (OR = 1.78, 95% CI = 1.05-3.3, P = 0.033), and edentulism/severe tooth loss (OR = 8.64, 95% CI = 3.19-23.87, P < 0.001) had significantly higher odds for poor OHrQoL. Edentulism/severe tooth loss was also significantly associated with undernutrition (OR = 12.5, 95% CI = 6.56-23.81, P < 0.001). Conclusion: The burden of dental caries and edentulism in rural South India was high. The prevalence of edentulism had a significant impact on the OHrQoL. This study highlights the need for researchers to understand the importance of edentulism and its impact on overall health of the elderly, thereby focusing on health programs inclusive of oral health promotion and prevention. [ABSTRACT FROM AUTHOR]

Background Antibiotics are commonly given for the treatment of childhood diarrhoea, but are not indicated in most cases. Antibiotics modify the gastrointestinal microbiota, which may have unanticipated effects on the risk of subsequent diarrhoea. Methods In a prospective observational cohort study, we assessed the effect of care-giver-reported antibiotic treatment for diarrhoea on the timing of a child's next episode among 434 children followed from birth to 3 years of age in Vellore, India. We estimated median time differences and time ratios from inverse probability of exposure-weighted Kaplan-Meier curves for the time to next diarrhoea episode, comparing children who did and did not receive antibiotics for the previous episode. Results Study children had more than five diarrhoea episodes on average in the first 3 years of life, and more than a quarter of all episodes were treated with antibiotics. Children who received antibiotics for their first diarrhoea episode had their second episode on average 8 weeks earlier (median time difference: -8, 95% confidence interval: -10, -3) than children who did not receive antibiotics. The effects of antibiotics on subsequent diarrhoea were greatest at earlier episodes and younger ages, and cefixime had a slightly larger effect compared with cotrimoxazole. Conclusions Antibiotic treatment of diarrhoea was associated with reduced time to a subsequent diarrhoea episode, especially among younger infants. Whereas rational use of antibiotics has been advocated to reduce antimicrobial resistance in populations, we show that overuse of antibiotics may also have a direct adverse effect on individual patients. [ABSTRACT FROM AUTHOR]

Background: Cryptosporidium spp. is a common, but under-reported cause of childhood diarrhea throughout the world, especially in developing countries. A comprehensive estimate of the burden of cryptosporidiosis in resource-poor settings is not available. Methodology/Principal Findings: We used published and unpublished studies to estimate the burden of diarrhea, hospitalization and mortality due to cryptosporidial infections in Indian children. Our estimates suggest that annually, one in every 6–11 children <2 years of age will have an episode of cryptosporidial diarrhea, 1 in every 169–633 children will be hospitalized and 1 in every 2890–7247 children will die due to cryptosporidiosis. Since there are approximately 42 million children <2 years of age in India, it is estimated that Cryptosporidium results in 3.9–7.1 million diarrheal episodes, 66.4–249.0 thousand hospitalizations, and 5.8–14.6 thousand deaths each year. Conclusions/Significance: The findings of this study suggest a high burden of cryptosporidiosis among children <2 years of age in India and makes a compelling case for further research on transmission and prevention modalities of Cryptosporidium spp. in India and other developing countries. Author Summary: Cryptosporidium spp. is a major cause of childhood diarrhea in India and other developing countries. Because of its link with poverty and its ability to impair childhood growth and development, Cryptosporidium spp. was included in the WHO Neglected Diseases Initiative in 2004. Despite this, the global impact of cryptosporidiosis is yet to be quantified due to the lack of country-specific estimates on cryptosporidial disease burden. In this study, we combined data from community-based studies in Vellore with the national statistics for India to obtain an estimate of the cryptosporidial disease burden in Indian children. Despite the inherent challenges in generating national estimates of disease burden for a country as large and diverse as India, our study provides a useful assessment of the under-recognized burden of cryptosporidiosis in Indian children. [ABSTRACT FROM AUTHOR]

Municipal water sources in India have been found to be highly contaminated, with further water quality deterioration occurring during household storage. Quantifying water quality deterioration requires knowledge about the exact source tap and length of water storage at the household, which is not usually known. This study presents a methodology to link source and household stored water, and explores the effects of spatial assumptions on the association between tap-to-household water quality deterioration and enteric infections in two semi-urban slums of Vellore, India. To determine a possible water source for each household sample, we paired household and tap samples collected on the same day using three spatial approaches implemented in GIS: minimum Euclidean distance; minimum network distance; and inverse network-distance weighted average. Logistic and Poisson regression models were used to determine associations between water quality deterioration and household-level characteristics, and between diarrheal cases and water quality deterioration. On average, 60% of households had higher fecal coliform concentrations in household samples than at source taps. Only the weighted average approach detected a higher risk of water quality deterioration for households that do not purify water and that have animals in the home (RR=1.50 [1.03, 2.18], p=0.033); and showed that households with water quality deterioration were more likely to report diarrheal cases (OR=3.08 [1.21, 8.18], p=0.02). Studies to assess contamination between source and household are rare due to methodological challenges and high costs associated with collecting paired samples. Our study demonstrated it is possible to derive useful spatial links between samples post hoc; and that the pairing approach affects the conclusions related to associations between enteric infections and water quality deterioration. [ABSTRACT FROM AUTHOR]