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Highlights • Elderly being married, acquiring resources and, practicing higher social action enjoy higher degree of social capital. • Elderly with higher degree of social capital are seen to experience better quality of life and healthy aging. • Social capital is signifcanly associated to lowering functional limitation, depression among eldelry. • High access to psychological resources regarding controlling important things in life put profound impact on the quality of life. • Emerging need to highlight the component of social capital in framing policy for elderly in India. Abstract Background Lacuna in contemporary Indian academic research highlights the need to investigate the component of social capital and health outcome among elderly individuals in Indian context. Study endeavors to investigate prevalence of health indicators: self-rated good health(SRH), functional limitation, depression and quality of life(QoL) and the illustrative effects of social capital on elderly health outcome and QoL. Methods Nationally representative cross-sectional data from WHO Study on global AGEing and adults health (SAGE) India 2007 is used. Individuals aged 50+ are included where logistic regression is used to estimate the effect of social capital along with other co-founders on SRH, functional limitation, and depression. Linear regression model is used to analyse evaluates the impact of social capital with other co-founders on QoL among elderly. Results The multivariate analysis shows that SRH is associated with age, female, those having education, higher social-action with strong trust, safety and higher psychological resources. Depression among elderly is significantly related to age, gender, education level, higher wealth, strong sociability. QoL is inversaly related to age, gender, being muslim. A positive association of QoL is observed with higher education, having wealth, and strong social capital component like currently married, civic engagement, social-action, trust solidarity,and strong psychological resources. Conclusion The paper presents evidence that social capital significantly associated with SRH, lower depression, better functional health and higher quality of life. Hench forth policy makers should construct social policy where elderly feel safe and trusty surrounding, that can involved them into main stream as a productive resource of society. [ABSTRACT FROM AUTHOR]

Objectives: This paper investigates severe partner perpetrated burn (SPPB) in India and associated social correlates.Methods: Data are from the National Family Health Survey (NFHS-3), a cross-sectional nationally representative household-based survey. Age, wealth index, education, urban/rural status, region, in-law violence, parental abuse, father abuse of mother, presence of a son, and age at marriage were examined for relationships with SPPB. Models with two reference groups were created (women without intimate partner violence; women with other non-burn intimate partner violence). Logistic regression analyses were computed.Results: Prevalence of SPPB was 1.00% (n=429). When compared to women with no intimate partner violence (IPV), greater wealth and rural status were protective of SPPB, but having a father who abused the participant's mother increased odds of SPPB over three times. When compared to women who had experienced IPV, presence of a son was protective of SPPB, as was not living in the South. Similarities between models included increased odds of SPPB associated with in-law violence and younger age at marriage.Conclusions: SPPB was associated with measures that impacted odds of its occurrence. Prevention efforts should consider these and other cultural factors. [ABSTRACT FROM AUTHOR]

Anaemia control programmes in India are hampered by a lack of representative evidence on anaemia prevalence, burden and associated factors for adolescents. The aim of this study was to: (1) describe the national and subnational prevalence, severity and burden of anaemia among Indian adolescents; (2) examine factors associated with anaemia at national and regional levels. Data (n = 14,673 individuals aged 10–19 years) were from India's Comprehensive National Nutrition Survey (CNNS, 2016–2018). CNNS used a multistage, stratified, probability proportion to size cluster sampling design. Prevalence was estimated using globally comparable age‐ and sex‐specific cutoffs, using survey weights for biomarker sample collection. Burden analysis used prevalence estimates and projected population from 2011 Census data. Multivariable logistic regression models were used to analyse factors (diet, micronutrient deficiencies, haemoglobinopathies, sociodemographic factors, environment) associated with anaemia. Anaemia was present in 40% of girls and 18% of boys, equivalent to 72 million adolescents in 2018, and varied by region (girls 29%–46%; boys 11%–28%) and state (girls 7%–62%; boys 4%–32%). Iron deficiency (ferritin < 15 μg/L) was the strongest predictor of anaemia (odds ratio [OR]: 4.68, 95% confidence interval [CI]: [3.21,6.83]), followed by haemoglobinopathies (HbA2 > 3.5% or any HbS) (OR: 2.81, 95% CI: [1.66,4.74]), vitamin A deficiency (serum retinol <20 ng/ml) (OR: 1.86, 95% CI: [1.23,2.80]) and zinc deficiency (serum zinc < 70 μg/L) (OR: 1.32, 95% CI: [1.02,1.72]). Regional models show heterogeneity in the strength of association between factors and anaemia by region. Adolescent anaemia control programmes in India should continue to address iron deficiency, strengthen strategies to identify haemoglobinopathies and other micronutrient deficiencies, and further explore geographic variation in associated factors. Key messages: The Comprehensive National Nutrition Survey (CNNS) 2016–2018 is the only nationally representative survey to measure haemoglobin, haemoglobinopathies, biomarkers of micronutrient deficiencies, diet and social factors in Indian adolescents aged 10–19 years.Using CNNS data, we found that 28.5% of adolescents (girls: 39.6%, boys: 17.6%) were anaemic, with variation by region or state.Our prevalence estimates translate to 72 million adolescents being anaemic, with Uttar Pradesh having twice as many anaemic adolescents as any other state.Iron deficiency, haemoglobinopathies, vitamin A deficiency and zinc deficiency were associated with an increased risk of anaemia; these associations may vary subnationally. [ABSTRACT FROM AUTHOR]

Multiple micronutrient deficiencies (MNDs) co‐exist, often because of poor intakes and adversely impact health. Habitual diets were assessed in 300 school children (6–17 years old) recruited from two government schools by simple random sampling. Probability of adequacy (PA) for 11 micronutrients and mean probability of adequacy (MPA) was calculated. Haemoglobin, plasma ferritin, folic acid, vitamin B12 and C‐reactive protein were estimated. Descriptive statistics and regression analysis were used to estimate magnitude and factors associated with MNDs. The contribution of fortified foods and/or supplements in addressing inadequacies and excessive intakes was modelled. The PA ranged from 0.04 for folate to 0.70 for zinc, and the MPA was 0.27. Prevalence of anaemia (53%), iron deficiency (57%; ID), iron deficiency anaemia (38%; IDA), folate deficiency (24%) and B12 deficiency (43%) was high. Dietary inadequacy of iron, zinc and a low MPA was associated with anaemia and IDA. Inclusion of double fortified salt (DFS), fortified rice (FR) or iron folic acid (IFA) supplements individually in habitual diet reduced probability of iron inadequacy significantly from 82% to ≤13%. Inclusion of DFS and FR simultaneously led to disappearance of iron inadequacy, but risk of excessive intake increased to 16%. Inclusion of DFS, FR and IFA together increased risk of excess iron intake to 40%. Nevertheless, intakes of folate and B12 remained inadequate even with FR and/or IFA. These results indicate a high risk of dietary MNDs in children and suggest need for more systematic intake measurements in representative sample and adjustment of iron dosages to avoid excessive intakes. [ABSTRACT FROM AUTHOR]

India is the home of more than 253 million adolescents, which account for almost 21% of the country's population. In the recent past, there has been a rise in the prevalence of mental illness and maladaptive behaviours among adolescents living in slum populations, which are increasing at an alarming rate in many developing countries, mainly due to rural–urban migration, are characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. This neglected population has become a major reservoir for a broad spectrum of adverse health conditions. Studies on the mental health status among adolescents in India are relatively scarce. The main objective of the study was to estimate the prevalence of mental health disorder and its determinants among adolescents in slum settings in Lucknow, India; by using GHQ-12. The study used cross-sectional primary data which was collected in 2015–2016 from the adolescents living in various slums of Lucknow city. About 590 adolescents whose parents gave consent to participate were included in the study. Descriptive statistics, Chi square test and ordered logistic regression analysis (OLR) technique were used to assess the mental health. Reliability of GHQ-12 was assessed before performing the analysis which was found to be 0.79. Approximately, 33% of adolescents were found to suffer from severe level of mental disorder. The results of this study depicts that adolescents of age 12–15 years had more severe mental health problems compares to 16–19 years of adolescents. Females were more likely to suffer from severe mental health problems compared to moderate/normal mental health problems (OR 1.72; p < 0.001). Odds of severe mental health problems was significantly higher among Muslims (OR 1.66; p < 0.001) than Hindus. Thus, it was found that age, gender, education, caste, household economic status, media exposure and religion to be significantly associated with mental health problem. Government should provide a wide range of adolescent friendly health services (clinical, mental, nutritional, including counselling) in these slums for a better adolescent health outcome. [ABSTRACT FROM AUTHOR]

Background. Tobacco smoking is a global epidemic among adults and increases the risk of different diseases, and premature deaths. Objectives. This study attempts to investigate and estimate the prevalence and risk factors of tobacco smoking among adults in India. Material and methods. This study utilized cross-sectional data from the nationally representative 2017 Global Adult Tobacco Survey. Chi-square analysis was used to show the association between tobacco smoking and risk factors. Binary logistic regression was used to determine the risk factors of tobacco smoking based on p-values and odds ratio along with confidence interval. Results. The overall prevalence of tobacco smoking was 12.84% (Male: 25.01%, Female: 2.63%). The highest prevalence of tobacco smoking was in Meghalaya (35.04%) and the lowest in Goa (3.07%). Genderwise, the highest prevalence of tobacco smoking was 57.27% in Meghalaya for males and 7.27% in Manipur for females. This study found that 16 out of 19 covariates were significantly (p < 0.001) associated with tobacco smoking. Age, region, gender, education, religion, marital status, wealth index, number of living persons, and presence of smoking persons were found to be highly significant (p < 0.001) risk factors. Adults from 46-60 years, north east region, no education, daily wage/casual labourers and self-employed, non-Hindu, married. Poorest, presence of smoking persons, and no knowledge about smoking cause strokes had significantly higher risk of tobacco smoking. Conclusions. Tobacco smoking remains one of the major causes of diseases, deaths and economic losses. This recent realistic evidence will help policy makers to make policy for reducing tobacco smoking in India, as well as different states. [ABSTRACT FROM AUTHOR]

Background: The prevalence of gastro-esophageal reflux disease (GERD) varies widely around the world. This study aimed to investigate the prevalence and risk factors of GERD in a general population of southern India.Methods: An interview-based observational study was carried out in southern India during 2010 and early 2011 using a GERD questionnaire (GerdQ). In total 1072 participants were enrolled using a multi-stage cluster sampling method. Presence of GERD was defined as a score of ≥ 8. Logistic regression models were used to derive odds ratios (ORs) with 95 % confidence intervals (CIs).Results: The prevalence of GERD was 22.2 % (238/1072) in southern India, and was more common among older subjects and men. Overweight and obese subjects had a dose-dependent increased risk of GERD, compared to those with body mass index less than 25 (multivariate-adjusted OR = 1.4, 95 % CI 1.0-2.0; OR = 2.3, 95 % CI 1.3-4.1, respectively). People residing in urban community were more vulnerable to GERD than those in rural community (multivariate-adjusted OR = 1.8, 95 % CI 1.3-2.5). Similarly, those with a lower educational level appeared to have an increased risk of GERD. Further, those with a habit of pan masala chewing were more likely to develop GERD compared with those abstained from the habit (multivariate-adjusted OR = 2.0, 95 % CI 1.2-3.2).Conclusions: GERD is highly prevalent in southern India. Increasing age and BMI, an urban environment, lower educational level, and pan masala chewing appear to be risk factors of GERD symptoms for the studied population. [ABSTRACT FROM AUTHOR]

Background: Childhood anemia is highly prevalent worldwide. Improving the hemoglobin level of preschool age children could yield substantial benefits in cognitive and psychosocial development and overall health. While evidence-based recommendations for reducing childhood anemia in high anemia prevalence countries are available, there is no experimental evidence of community centered education and counseling programs, as a route to improved acceptance of iron supplements, demonstrating beneficial effects on anemia outcomes. We report on the evaluation protocol of a complex educational intervention led by the community lay health worker (LHW) and delivered to mothers of 12-59-month-old anemic children living in and visiting village day care centers in a large district of southern India.Methods and Design: The study is designed as a cluster randomized controlled trial. The intervention is based on the social cognitive theory and aims to promote among mothers, anemia awareness, dietary modifications to increase iron intake in the child, and recognition of the need for enhanced adherence to supplemental iron in the anemic child. From 270 eligible villages in the study area, a sample of 60 villages will be randomized to intervention [n = 30] or to treatment as usual [n = 30] of the study. LHWs in the intervention arm will be trained to administer the following intervention components to mothers of anemic children: 1] monthly distribution of Iron and folic acid (IFA) supplements to mothers of anemic children, and 2] five monthly counseling sessions of mothers of anemic children covering: a] anemia awareness education b] IFA adherence counseling and assessment, c] dietary modification to improve iron intake, and d] hygiene and sanitation. LHWs in the control arm will distribute IFA to mothers of anemic children as in the intervention arm but will not provide monthly education and counseling support. The primary outcome is the difference between the two experimental groups in anemia cure rates of children found to be anemic at baseline. Secondary outcomes, assessed as differences between all participants in both experimental groups, are: change in mothers' knowledge regarding anemia; 24 hour dietary iron intake; net improvement in individual hemoglobin values; serum ferritin; and the difference in overall cluster level childhood anemia prevalence. All outcomes will be measured 6 months after the start of the intervention. Multilevel linear and logistic regression models will be used to analyze differences between intervention and control groups in outcome variables.Discussion: This trial is designed to evaluate the effectiveness of an intervention intended to improve anemia cure rates in anemic children living in villages of Chamarajnagar, Karnataka a large district in south India. The extensive study of secondary endpoints will be used to identify possible weak points in the compliance to intervention delivery and uptake. This evaluation is one of the few large randomized trials evaluating the impact of an education and counseling intervention to reduce childhood anemia prevalence.Trial Registration: This trial was registered with ISRCTN.com (identifier: ISRCTN68413407) on 17 September 2013. [ABSTRACT FROM AUTHOR]