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Context: Chronic diseases are growing in India and largely affecting the middle-aged and elderly population; many of them are in working age. Though a large number of studies estimated the out-of-pocket payment and financial catastrophe due to this condition, there are no nationally representative studies on productivity loss due to health problems. This paper examined the pattern and prevalence of productivity loss, due to chronic diseases among middle-aged and elderly in India. Methods: We have used a total of 72,250 respondents from the first wave of Longitudinal Ageing Study in India (LASI), conducted in 2017-18. We have used two dependent variables, limiting paid work and ever stopped work due to ill health. We have estimated the age-sex adjusted prevalence of ever stopped working due to ill health and limiting paid work across MPCE quintile and socio- demographic characteristics. Propensity Score Matching (PSM) and logistic regression was used to examine the effect of chronic diseases on both these variables. Findings: We estimated that among middle aged adults in 45–64 years, 3,213 individuals accounting to 6.9% (95%CI:6.46–7.24) had ever-stopped work and 6,300 individuals accounting to 22.7% (95% CI: 21.49–23.95) had limiting paid work in India. The proportion of ever-stopped and limiting work due to health problem increased significantly with age and the number of chronic diseases. Limiting paid work is higher among females (25.1%), and in urban areas (24%) whereas ever-stopped is lower among female (5.7%) (95% CI:5.16–6.25) and in urban areas (4.9%) (95% CI: 4.20–5.69). The study also found that stroke (21.1%) and neurological or psychiatric problems (18%) were significantly associated with both ever stopped work and limiting paid work. PSM model shows that, those with chronic diseases are 4% and 11% more likely to stop and limit their work respectively. Regression model reveals that more than one chronic conditions had a consistent and significant positive impact on stopping work for over a year (increasing productivity loss) across all three models. Conclusion: Individuals having any chronic disease has higher likelihood of ever stopped work and limiting paid work. Promoting awareness, screening and treatment at workplace is recommended to reduce adverse consequences of chronic disease in India. [ABSTRACT FROM AUTHOR]

Background: Age is one of the predominant reasons for perceived discrimination in developing world where older people are considered a non-contributing burden. The present study explores the prevalence and correlates of perceived age discrimination among older Indian adults.Methods: A cross-sectional study was conducted using a large representative survey data from the Longitudinal Ageing Study in India conducted during 2017-18. Participants included 31,464 older adults aged 60 years and above. Multivariable logistic regression analysis was used to test the associations between selected background characteristics and perceived age discrimination.Results: The analysis revealed that 10.33 percent of older adults perceived their age as the main reason for discrimination, which was 11.86% among the oldest-old. Older adults with more than 10 years of schooling were 32% [adjusted odds ratio (AOR): 0.68; confidence interval (CI): 0.51-0.89] less likely to perceive age discrimination compared to their uneducated counterparts. The odds of perceived age discrimination were higher among older adults who earlier worked [AOR: 1.73; CI: 1.46-2.05] and currently working [AOR: 1.61; CI: 1.31-1.96] as compared to those who never worked. Further, having difficulty in instrumental activities of daily living (IADL) [AOR: 1.43; CI: 1.25 -1.65] and having one chronic condition [AOR: 1.16; CI: 1.02 -1.34] were associated with increased odds of perceived age discrimination among older adults.Conclusion: Older adults with lower socioeconomic status, currently working, having more chronic conditions, difficulty in IADL and belonging to rural areas were found to perceive higher age discrimination than their counterparts. The findings of the study have important implications for policy makers with respect to strategies such as making the vulnerable populations aware of their legal rights that help in the prevention of age-based discrimination in the country. [ABSTRACT FROM AUTHOR]

Background: Our earlier Google Trend (GT) Analytics study reported that the worldwide human population severely subject to four seasonal (sensitive) comorbid lifestyle diseases (SCLD) such as asthma, obesity, hypertension and fibrosis. The human population subject to seasonal variability in these four diseases activity referred as "severe seasonal sensitive population". In India, the estimated burden of these four seasonal diseases is more than 350 million as on the year 2018. It is a growing crisis for India with a projected disease burden of 500 million in the year 2025. This study was aimed to decipher the genuine SCLD seasonal trends in the entire Indian population using GT and validate these trends in Indian climatic zones.Methods: GT is used to study the temporal trends in web search using weekly Relative Search Volume (RSV) for the period 2004 to 2017. The relative search volume (RSV) of the four-severe seasonal comorbid diseases namely Asthma, Hypertension, Obesity and Fibrosis were collected with and without obesity as the reference. The RSV were collected using the GT selection options as (i) Whole India (ii) Jammu and Kashmir (Cold zone) (iii) Rajasthan (Hot and Dry zone) (iii) West Bengal (Hot and Humid zone) and (iv) Uttar Pradesh state (Composite zone). The time series analysis was carried out to find seasonal patterns, comorbidity, trends and periodicity in the entire India and four of its states (zones).Results: Our analysis of entire India (2004-2017) revealed high significant seasonal patterns and comorbidity in all the four diseases of SCLD. The positive tau values indicated strong positive seasonal trends in the SCLD throughout the period (Table). The auto correlation analysis revealed that these diseases were subjected to 3, 4 and 6 months period seasonal variations. Similar seasonal patterns and trends were also observed in all the four Indian temperature zones. Overall study indicated that SCLD seasonal search patterns and trends are highly conserved in India even in drastic Indian climatic zones.Conclusions: The clinical outcome arise out of these observations could be of immense significance in handling the major chronic life style diseases asthma, hypertension, obesity and fibrosis. The possible strong comorbid relationship among asthma, hypertension, obesity and fibrosis may be useful to segregate Indian seasonal sensitive population. In disease activity-based chronotherapy, the search interest of segment of the population with access to Internet may be used as an indicator for public health sectors in the early detection of SCLD from a specific country or a region. As this disease population could be highly subject to the adverse effect of seasons in addition to life style and other environmental factors. Our study necessitates that these Indian populations need special attention from the Indian health care sectors. [ABSTRACT FROM AUTHOR]

Background: The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs.Methods: Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007-10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557).Results: A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina.Conclusion: Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems. [ABSTRACT FROM AUTHOR]

Background: The epidemiological knowledge on acute condition of lymphatic filariasis is essential to understand the burden and issues on management of the disease. Methods: A one year long longitudinal prospective surveillance of acute adenolymphangitis (ADL) was carried out in rural population of Orissa, India. Results: The annual incidence of ADL per 1000 individuals is 85.0, and is slightly higher (P > 0.05) in male (92.0) than in female (77.6). A steady rise in the incidence of ADL episodes along with the age is recorded. The distribution indicates that persons with chronic disease are more prone to ADL attacks. The average number of episodes per year is 1.57 (1.15 SD) per affected person, and is gender dependent. Duration of the episode varies from 1 to 11 days with mean duration of 3.93 (1.94 SD) days. The chronic disease is the significant predictor for the duration of the episode. The data show that fever and swelling at inguinal regions are most common symptoms. Conclusion: The incidence, frequency and duration of ADL episodes in this community are similar to that of other endemic areas. As the loss due to these ADL episodes is substantial, it should be considered while further estimating the burden due to lymphatic filariasis. The disability and loss caused by chronic forms of filariasis is higher, and the additional incapacity caused by the ADL episode, majority of which occur among chronic filariasis patients, further poses the burden on individuals and their families. Hence, morbidity management measures to prevent ADL episodes among endemic communities are to be implemented. [ABSTRACT FROM AUTHOR]