Urban Slum Residents Research Articles

Urban slum housing quality, and its public health implications in Nigeria: a case of urban slum residents in Enugu metropolis, South East, Nigeria

IntroductionHousing remains a strategic social determinant of health. In Sub-Saharan Africa, most urban dwellers live in slums with attendant health implications. This study assessed the housing conditions of the slums of Enugu metropolis and the public health implications.MethodsThis is a community-based cross-sectional study of 459 slum residents of the Enugu metropolis. Ethical clearance was obtained from the UNTH, Health Research Ethics Committee (HREC). Data was collected using a pretested semi-structured interviewer-administered questionnaire and an observational checklist. Data was analysed using IBM SPSS version 23. Data were summarised using mean and standard deviation, frequency and proportion as appropriate and presented in tables and figures. The chi-square test was used for association at p-value ≤ 0.05 significance.ResultsThe mean age (SD) of the respondents was 32.93(12.34) years. A higher proportion (N = 180, 39.2%) were 18-27years, females (N = 282, 61.4%), married (N = 297, 64.7%), attained secondary education (N = 273, 59.5%), Igbo (N = 453, 98.7%), and self-employed (N = 327, 71.2%). They demonstrated good knowledge of standard housing specifications (N = 231, 50.3%) and the effects of housing conditions on health (N = 297, 64.7%). Also, most lived in a one-room apartment (N = 201, 43.8%) and cooked in a separate kitchen (N = 150, 32.7%) with a gas cooker as the major source of heat supply for cooking (N = 249, 54.2%). Sixty-three (13.7%) of the respondents didn’t have access to suitable toilet facilities. A higher proportion, (N = 171, 37.3%) used pipe-borne water, and electricity as the major source of light (N = 447, 97.4%). The most prevailing health condition was malaria/fever (N = 258, 97.4%). Despite having pests and rodents-infested dwellings, only (N = 156, 34.0%) had insecticides in the house. Equally, (N = 132, 28.8%) of them lived with broken floors.ConclusionsDespite good knowledge of the public health implications of poor housing, most dwellings remained substandard and unhealthful with associated prevalent health conditions.RecommendationThere is a need for a health campaign against the poor living conditions in the slums.

Patronage Pattern and Accessibility of Healthcare Facilities in Urban Slums and Informal Settlements in Ibadan Metropolis

Slums and informal settlements are residential areas physically and socially disintegrated. In spite of this, inadequate health-related data on slum areas and informal settlements has led to inappropriate and unrealistic allocation of healthcare resources by the public and private health providers. This study investigates the patronage pattern and accessibility of healthcare facilities to residents of urban slums and Informal settlements in Ibadan Metropolis, a rapidly growing urban area in Nigeria facing challenges related to urbanization and healthcare infrastructure. Data were collected from both primary and secondary sources. Structured questionnaire was administered on 1,389 residents of the slummy neighbourhoods and informal settlements in Ibadan metropolis, and obtained data were analyzed using descriptive and inferential statistics. Results revealed that out of 109 neighbourhoods, 42.1% were categorized as slummy neighbourhoods, 36.7% as slums/informal settlements, while 21.2% were informal settlement using slummy and informality conditions respectively. Results revealed that distance to health facility (β= -0.353, p<0.05), educational qualification (β=-0.063, p<0.05) and household size (β= -0.052, p<0.05) had an inverse relationship with patronage of health facilities, while age (β=0.086, p< 0.05) had a positive relationship. It was also revealed that access to PHC and dispensary/clinic in slummy neighbouhoods and slum/informal settlements is higher compared to informal settlements in the study area. The study therefore recommends implementation of slum improvement program for the slummy and slums/informal neighbourhoods, provision of additional healthcare facilities to be located especially in the slummy neighbourhoods and informal settlements to ensure equitable distribution.

Knowledge, Attitude, and Awareness of Organ Donation among Residents of Urban Slums in Chennai, Tamil Nadu

Knowledge, Attitude, and Awareness of Organ Donation among Residents of Urban Slums in Chennai, Tamil Nadu

The Allegory of the Favela: The Multifaceted Effects of Socioeconomic Mobility

What are the consequences of upward socioeconomic mobility for disenfranchised individuals? This article examines this question in the context of a business training program offered to residents of Brazilian urban slums, known as “favelas.” The study employs a randomized controlled trial complemented by quantile regressions, field visits, and interviews. The results show that training improves favela dwellers’ economic outcomes, such as by increasing income and participation in entrepreneurship, and some socio-psychological outcomes, such as by improving self-efficacy and optimism. However, these income improvements were accompanied by participants’ enhanced experiences of favela stigma, an adverse socio-psychological outcome related to their residential segregation. Both quantitative and qualitative findings demonstrate the multifaceted nature of socioeconomic mobility, through which favela dwellers who prosper economically become more exposed to prejudice from people living outside favelas. The study illustrates, through the “allegory of the favela,” the bittersweet process of socioeconomic mobility. This abductive research contributes to the literature by showing that while interventions designed to enfranchise individuals may effectively achieve economic inclusion in terms of income gains, they may simultaneously lead participants into discriminatory systems that further stigmatize people based on the same characteristics of their prior exclusion.

Oral rehydration therapy and Zinc treatment among diarrhoeal children in India: Exploration from latest cross-sectional National Family Health Survey.

Diarrhoea is one of the deadliest diseases and causing death among children in India, but no systematic attempt is made to understand it especially its control using oral rehydration salts (ORS). It is well known that use of ORS and Zinc have been effective in containing diarrhoea among children. An attempt is made using large scale national data set in India to understand use of ORS and Zinc to control diarrhoea and their associated factors among diarrhoeal children under five in India. Publicly available most recent cross-sectional National Family Health Survey data in India was used for the study. The multi-stage cluster sampling design was used with 2011 Census of India as a sampling frame. Households were selected using a Systematic Random Sampling design from selected primary sampling units in rural and urban clusters. From the selected households, the eligible children were those who suffered from diarrhoea in the two weeks preceding the survey and were less than 5 years old. Using this criterion, out of 232,920 children in the survey of less than five years, 16,213 sample diarrheal children found to be available for the study. Both descriptive and inferential statistical techniques were used to analyse the data. Across India, 61% and 31% of the children were given ORS and Zinc respectively. However, combined ORS + Zinc treatment was only around 24%. The treatment of ORS, Zinc, and combined ORS + Zinc supplementations were significantly higher among younger children, children of 24-35 age group mothers, children from rich wealth index groups, belong to Hindu religion and general caste compared to their counterparts. The logistic regression results showed that consumption of ORS among diarrhoeal children under five years of age depends upon size of a child at birth. For instance, diarrheal children who were very small size at birth compared to very large at birth, had 39% lower odds of consuming ORS (AOR = 0.61; CI 0.48, 0.78; p<0.001). Another important variable is place of first treatment sought for diarrheal children. That is children who first sought treatment in private hospital compared to government hospital had 52% lower odds of ORS consumption. The logistic regression adjusted AORs are similar with Zinc and ORS + Zinc supplementations. To improve the coverage and management of childhood diarrhoea in India, planning activities should focus not only on distribution, and increasing knowledge of ORS preparation especially for urban slum residents and rural disadvantaged groups through demonstration. There should be also proper focus on providing ongoing pathways to ensure proper supply chains.

Integrating health belief model and theory of planned behavior to assess COVID-19 vaccine acceptance among urban slum people in Bangladesh.

The vaccination against coronavirus disease 2019 (COVID-19) has been identified as a promising strategy to reduce the severity of the pandemic. Despite the safe and effective COVID-19 vaccines, bringing socioeconomically disadvantaged people under vaccination coverage has been challenging for developing countries like Bangladesh. Therefore, this study explored the determinants of vaccine acceptance among urban slum residents of Bangladesh using the Health Belief Model (HBM) and Theory of Planned Behavior (TPB). A face-to-face survey of 400 urban slum dwellers in two large cities in Bangladesh was conducted between July 5 to August 5, 2021. The questionnaire included vaccine acceptance, socio-demographics, health-related characteristics, trust in health authorities, reasons for vaccine hesitancy, and dimensions of HBM and TPB frameworks. Hierarchical logistic regression was performed to evaluate the association between these characteristics and vaccination acceptance. Around 82% (n = 327) of respondents were willing to accept the COVID-19 vaccine. In a fully adjusted model, respondents with secondary level education had higher intention (OR = 46.93, 95%CI = 1.21-1807.90, p < 0. 05) to accept COVID-19 vaccine. Respondents with bad (OR = 0.11, 95%CI = 0.01-0.35, p<0.05) or very bad (OR = 0.01, 95%CI = 0.01-0.35, p<0.05) health conditions were less interested in the COVID-19 vaccination. In regard to HBM dimensions, greater perceived susceptibility (OR = 1.75, 95% CI = 1.12-2.75, p < 0.05), and perceived benefits (OR = 3.28, 95% CI = 1.17-6.00, p < 0.001) were associated with a greater willingness to get vaccinated. In regard to TPB, higher self-efficacy in preventing illness without the vaccine increased the desire to get vaccinated (OR = 1.55, 95% CI = 1.02-2.37, p < 0.05). Fear of unknown side effects, religious beliefs, contraindications to vaccination, and insufficient information on the vaccine were the main reasons for vaccine hesitancy. These findings offer valuable insights for policymakers in Bangladesh to design targeted interventions that address vaccine hesitancy and increase vaccination acceptability among socially disadvantaged individuals in urban areas. Strategies should focus on providing accurate and accessible information about the vaccine, communicating its positive impact effectively, engaging with religious leaders to address misconceptions, and tailoring vaccination campaigns to meet the unique needs of different demographic groups.

Protocol for the formative phase of a trial (SHE-CAN) to test co-designed implementation strategies for HPV-based cervical screening among vulnerable women in two diverse settings in India

BackgroundIn view of the WHO’s call for the elimination of cervical cancer as a public health problem, and current low screening coverage, Indian policy makers need evidence on how to effectively implement cervical screening programmes, ensuring equity in access.Our study will follow the INSPIRE implementation framework to co-design and test HPV-based screening approaches in two states of India with different health system organisation, based on understanding the status of screening as currently implemented, readiness and challenges to transition to HPV-based screening, and preferences of key stakeholders. Here, we describe our protocol for the formative phase of the study (SHE-CAN).MethodsThe study population includes women from vulnerable populations, defined as residents of tribal areas, rural villages, and urban slums, in the states of Mizoram and Tamil Nadu. The baseline assessment will use mixed methods research, with desktop reviews, qualitative studies, and surveys. A capacity assessment survey of screening and treatment facilities will be done, followed by interviews with healthcare providers, programme managers, and community health workers. Interviews will be conducted with previously screened women and focus group discussions with under and never-screened women and community members. Stakeholder workshops will be held in each state to co-design the approaches to delivering HPV-based screening among 30–49-year-old women.DiscussionThe quality and outcomes of existing screening services, readiness to transition to HPV-based screening, challenges in providing and participating in the cervical cancer care continuum, and acceptability of screening and treatment approaches will be examined. The knowledge gained about the current system, as well as recognition of actions to be taken, will inform a stakeholder workshop to co-design and evaluate implementation approaches for HPV-based screening through a cluster randomised implementation trial.

A Literature Review on Perceptions and Practices Related to Healthcare and Nutrition Amongst the Residents of Urban Slums Across India.

Urban regions are home to more than a billion people worldwide; by 2030, more than half of the world's population is projected to reside there. Many rural residents relocate to urban regions in pursuit of employment, better living conditions, and access to healthcare facilities. The study's primary objective is to collate the findings related to perceptions, knowledge, attitude, and practices from studies across the urban slums in India related to healthcare and nutrition. A systematic search of articles was conducted on the National Library of Medicine PubMed Portal Google Scholar, and J-Stor databases for published studies across the indexed journals. Academic social media sites like Academia.edu and Researchgate.org were also searched for grey literature.The inclusion criteria include studies conducted in Urban slums from 2010 to 2022, conducted amongst the Indian population within the Indian Geography, and focusing on documenting perceptions, knowledge, attitude, and practices. Exclusion criteria were cross-sectional surveys with quantitative questionnaires focusing on the prevalence of diseases and the burden of risk factors, literature reviews, systematic reviews, frameworks for implementation of specific interventions, and experimental study designs. A total of 18 qualitative observational studies were included in the review and the findings related to knowledge, attitudes, and practices identified from the literature were summarized. The literature indicated adequate knowledge about nutrition and healthcare, and the barriers towards transitioning knowledge to practice were related to lack of resources, priorities around employment and income, and the attitudes towards change-making were usually based on convenience to access cost of service and availability of the services. The review recommends further investment in research to understand the perceptions, patterns of nutrition, and health-seeking behaviours. Also, there is a pressing need to use the evidence for developing policies in line with the expectations of poor urban communities.

What influences slum residents' choices of healthcare providers for common illnesses? Findings of a Discrete Choice Experiment in Ibadan, Nigeria.

Urban slum residents have access to a broad range of facilities of varying quality. The choices they make can significantly influence their health outcomes. Discrete Choice Experiments (DCEs) are a widely-used health economic methodology for understanding how individuals make trade-offs between attributes of goods or services when choosing between them. We carried out a DCE to understand these trade-offs for residents of an urban slum in Ibadan, Nigeria. We conducted 48 in-depth interviews with slum residents to identify key attributes influencing their decision to access health care. We also developed three symptom scenarios worded to be consistent with, but not pathegonian of, malaria, cholera, and depression. This led to the design of a DCE involving eight attributes with 2-4 levels for each. A D-efficient design was created, and data was collected from 557 residents between May 2021 and July 2021. Conditional-logit models were fitted to these data initially. Mixed logit and latent class models were also fitted to explore preference heterogeneity. Conditional logit results suggested a substantial Willingness-to-pay (WTP) for attributes associated with quality. WTP estimates across scenarios 1/2/3 were N5282 / N6080 / N3715 for the government over private ownership, N2599 / N5827 / N2020 for seeing a doctor rather than an informal provider and N2196 / N5421 /N4987 for full drug availability over none. Mixed logit and latent class models indicated considerable preference heterogeneity, with the latter suggesting a substantial minority valuing private over government facilities. Higher income and educational attainment were predictive of membership of this minority. Our study suggests that slum residents value and are willing to pay for high-quality care regarding staff qualifications and drug availability. It further suggests substantial variation in the perception of private providers. Therefore, improved access to government facilities and initiatives to improve the quality of private providers are complementary strategies for improving overall care received.

PUBLIC PROVISION IN WATER AND SANITATION: AN INTER DISTRICT STUDY OF URBAN SLUMS IN JAMMU AND KASHMIR

There seems to be an expanding slum population that has put a lot of pressure on the existing infrastructure,Drinking water and sanitation in particular.The condition is worrying because water and sanitary services have been inadequately supplied and implemented inadequatelyWith the Fluctuating condition of Jammu and Kashmir, delivering crucial facilities such as drinking water and sanitation should be a government policy priority for urban slum residents. The GOI has been incorporating certain programmes at the national as well as at the state level to Poverty alleviation, job creation and the promotion of planned urban development in public policy, yet due to the number of factors, urban slums in J&amp;K have rapidly Increased. The objective of the paper is to test whether the provisioning of drinking water and sanitation is equitable or not across the districts. In this study we will use correlation coefficient and regression. The study uses data from various sources on the basis of secondary data. The study is also different in many aspects like data collection, time period and policy implications and gives some suggestions like Dreadful need for good governance at all government levels.

Magic, metaphysics, and methods

Magic, metaphysics, and methods

Knowledge, Awareness and Prevalence of Hepatitis B Among Urban Slum Dwellers and Residents of Social Welfare Home: A Cross sectional Study From Eastern India

In view of limited data on the knowledge and awareness of hepatitis B virus (HBV) and the available preventive strategies at the community level, it was aimed to analyse the knowledge and awareness of HBV in the community. A cross-sectional questionnaire-based survey was conducted among residents of an urban slum and a social welfare home in Bhubaneswar, Odisha, from October 2019 to April 2021. The prevalence of HBV infection was also measured by testing the serum positivity for hepatitis B surface antigen using rapid point-of-care test kits. The statistical analysis was done by using the software SPSS version 20. A total of 370 individuals (mean age 38.7±14.9 years, males: 55.1%) were assessed. Although 18.1% (67) had good knowledge, only 16.7% (62) had good awareness about HBV. Approximately 14.8% (55) knew that a vaccine is available in the country for HBV, and 6.2% (23) identified themselves as being vaccinated. Educational status was a significant independent predictor of knowledge and awareness such that people with education level of matriculation and above had odds of 11.05 (95% confidence interval: 5.3-22.7) and 14.7 (95% confidence interval: 6.5-33.1) for having good knowledge and awareness regarding HBV, respectively. A total of 10 participants tested positive for hepatitis B surface antigen contributing to a point prevalence rate of 2.7%. The proportion of individuals with an education status of matriculation and above was higher in the slum area when compared with the welfare home (67% vs 33%; P<0.001), the knowledge (71.6% vs 28.4%; P<0.001) and so was the awareness (71% vs 29%; P<0.001) about HBV as well. The relatively low figures of knowledge and awareness identified in our study undermine the need for intensification of health education and promotion activities regarding the prevalence of hepatitis B infection on a large scale at the community level.

Heat Exposure, Heat-Related Symptoms and Coping Strategies among Elderly Residents of Urban Slums and Rural Vilages in West Bengal, India.

The impact of heat stress among the elderly in India—particularly the elderly poor—has received little or no attention. Consequently, their susceptibility to heat-related illnesses is virtually unknown, as are the strategies they use to avoid, or deal with, the heat. This study examined perceptions of comfort, heat-related symptoms, and coping behaviors of 130 elderly residents of Kolkata slums and 180 elderly residents of rural villages south of Kolkata during a 90-day period when the average 24-h heat indexes were between 38.6 °C and 41.8 °C. Elderly participants in this study reported being comfortable under relatively warm conditions—probably explained by acclimatization to the high level of experienced heat stress. The prevalence of most heat-related symptoms was significantly greater among elderly women, who also were more likely to report multiple symptoms and more severe symptoms. Elderly women in the rural villages were exposed to significantly hotter conditions during the day than elderly men, making it likely that gender differences in symptom frequency, number and severity were related to gender differences in heat stress. Elderly men and elderly village residents made use of a greater array of heat-coping behaviors and exhibited fewer heat-related symptoms than elderly women and elderly slum residents. Overall, heat measurements and heat-related symptoms were less likely to be significant predictors of most coping strategies than personal characteristics, building structures and location. This suggests that heat-coping behaviors during hot weather were the result of complex, culturally influenced decisions based on many different considerations besides just heat stress.

Structural factors associated with SARS-CoV-2 infection risk in an urban slum setting in Salvador, Brazil: A cross-sectional survey.

BackgroundThe structural environment of urban slums, including physical, demographic, and socioeconomic attributes, renders inhabitants more vulnerable to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Yet, little is known about the specific determinants that contribute to high transmission within these communities. We therefore aimed to investigate SARS-CoV-2 seroprevalence in an urban slum in Brazil.Methods and findingsWe performed a cross-sectional serosurvey of an established cohort of 2,041 urban slum residents from the city of Salvador, Brazil between November 2020 and February 2021, following the first Coronavirus Disease 2019 (COVID-19) pandemic wave in the country and during the onset of the second wave. The median age in this population was 29 years (interquartile range [IQR] 16 to 44); most participants reported their ethnicity as Black (51.5%) or Brown (41.7%), and 58.5% were female. The median size of participating households was 3 (IQR 2 to 4), with a median daily per capita income of 2.32 (IQR 0.33–5.15) US Dollars.The main outcome measure was presence of IgG against the SARS-CoV-2 spike protein. We implemented multilevel models with random intercepts for each household to estimate seroprevalence and associated risk factors, adjusting for the sensitivity and specificity of the assay, and the age and gender distribution of our study population. We identified high seroprevalence (47.9%, 95% confidence interval [CI] 44.2% to 52.1%), particularly among female residents (50.3% [95% CI 46.3% to 54.8%] versus 44.6% [95% CI 40.1% to 49.4%] among male residents, p < 0.01) and among children (54.4% [95% CI 49.6% to 59.3%] versus 45.4% [95% CI 41.5% to 49.7%] among adults, p < 0.01). Adults residing in households with children were more likely to be seropositive (48.6% [95% CI 44.8% to 52.3%] versus 40.7% [95% CI 37.2% to 44.3%], p < 0.01). Women who were unemployed and living below the poverty threshold (daily per capita household income <$1.25) were more likely to be seropositive compared to men with the same employment and income status (53.9% [95% CI 47.0% to 60.6%] versus 32.9% [95% CI 23.2% to 44.3%], p < 0.01). Participation in the study was voluntary, which may limit the generalizability of our findings.ConclusionsPrior to the peak of the second wave of the COVID-19 pandemic, cumulative incidence as assessed by serology approached 50% in a Brazilian urban slum population. In contrast to observations from industrialized countries, SARS-CoV-2 incidence was highest among children, as well as women living in extreme poverty. These findings emphasize the need for targeted interventions that provide safe environments for children and mitigate the structural risks posed by crowding and poverty for the most vulnerable residents of urban slum communities.

Demand and supply-side barriers and opportunities to enhance access to healthcare for urban poor populations in Kenya: a qualitative study

ObjectiveTo explore the barriers to and options for improving access to quality healthcare for the urban poor in Nairobi, Kenya.Design and participantsThis was a qualitative approach. In-depth interviews (n=12), focus...

Community seroprevalence and risk factors for SARS-CoV-2 infection in different subpopulations in Vellore, India, and their implications for future prevention

ObjectivesThe aim of this study was to inform public health policy decisions through the assessment of IgG antibody seroprevalence in the population and the risk factors for SARS-CoV-2 infection. MethodsThe seroprevalence of IgG antibodies among different subpopulations at the end of the first and second waves of the pandemic was estimated. Various risk factors associated with seropositivity, including sociodemography, IgG antibodies against endemic human coronavirus, and vaccination status, were also assessed. ResultsFor all 2433 consenting participants, the overall estimated seroprevalences at the end of first and second waves were 28.5% (95% CI 22.3–33.7%) and 71.5% (95% CI 62.8–80.5%), respectively. The accrual of IgG positivity was heterogeneous, with the highest seroprevalences found in urban slum populations (75.1%). Vaccine uptake varied among the subpopulations, with low rates (< 10%) among rural and urban slum residents. The majority of seropositive individuals (75%) were asymptomatic. Residence in urban slums (OR 2.02, 95% CI 1.57–2.6; p < 0.001), middle socioeconomic status (OR 1.77, 95% CI 1.17–2.67; p = 0.007), presence of diabetes (OR 1.721, 95% CI 1.148–2.581; p = 0.009), and hypertension (OR 1.75, 95% CI 1.16–2.64; p = 0.008) were associated with seropositivity in multivariable analyses. ConclusionAlthough considerable population immunity has been reached, with more than two-thirds seropositive, improved vaccination strategies among unreached subpopulations and high-risk individuals are suggested for better preparedness in future.

Water, Sanitation, and Hygiene Practices in Urban Slums of Eastern India.

BackgroundThe Sustainable Development Goals identified universal access to water and sanitation facilities as key components for improving health. We assessed water, sanitation, and hygiene (WASH) practices and associated determinants among residents of urban slums in Kolkata, India.MethodsInformation on WASH practices was collected in 2 surveys (2018 and 2019) from participants of a prospective enteric fever surveillance conducted in 2 municipal wards of Kolkata. A composite WASH practice score was computed and a hierarchical stepwise multiple linear regression model constructed to identify key determinants of improved WASH score.ResultsOver 90% of households had access to piped water; 6% reported access to continuous supply. Adult women (61% in 2018; 45% in 2019) spent 20 minutes daily to fetch water. Access to improved latrines was almost universal, although 80% used shared facilities. Unhealthy disposal of children’s stools was reported in both rounds. Food hygiene practices were high, with most (>90%) washing uncooked items before eating; frequent consumption of street food items was reported.ConclusionsThe study area reported high WASH coverage. Unhygienic behavioral patterns predisposing to food- or water-borne diseases were also noted. Awareness building and sustainable community mobilization for food hygiene needs to be emphasized to ensure community well-being.

Psychological distress, low-income, and socio-economic vulnerability in the COVID-19 pandemic

ObjectivesAlthough literature broadly reports the impact of COVID-19 on global mental health, little is known about the extent of its deleterious impact on the most vulnerable individuals. The present study aimed to evaluate the level of psychological distress of adult's residents of two urban shantytown communities located in São Paulo city, Brazil. Study designThis was a cross-sectional study. MethodsAn online questionnaire was divided into four sections: (1) informed consent, (2) socio-economic data, (3) 12-item general health questionnaire, and (4) Brazilian food insecurity scale was applied. ResultsOf the 495 family headship (448 females and 47 males), the mean age was 36.1 years, 85% have an indication of psychological distress, 61.4% had a monthly income less than or equal to $70, and the incidence of households experiencing moderate or severe food insecurity was 40%. Multivariate logistic regression revealed that respondents who experienced moderate or severe food insecurity (odds ratio [OR] = 2.701, confidence interval [CI] 95% = 1.265–5.769; P = 0.010) and lower monthly income (OR = 2.031, CI 95% = 1.056–3.908; P = 0.034) had a higher risk of psychological distress. On the other hand, having an employment is a protective factor against the stressful situations caused by COVID-19 pandemic (P = 0.029). ConclusionThe present study identified low-income younger women residents of urban slums who suffer from food insecurity as high-risk groups to have psychological distress. Our findings are of particular importance because they showed the intersection of vulnerabilities during the COVID-19 outbreak.

Dietary salt intake and its correlates among adults in a slum area in Dhaka, Bangladesh: a cross-sectional study.

ABSTRACTHigh dietary salt intake increases the risk of noncommunicable diseases (NCDs). NCDs are increasing among the urban poor in Bangladesh, but the data of their dietary salt intake are yet scarce. This study aimed to explore the amount of dietary salt intake among adults in an urban slum area in Dhaka, Bangladesh. A cross-sectional community-based study was conducted. We randomly selected 100 residents (39 men and 61 women) aged 20–59 years without history of NCDs. A modified World Health Organization standard instrument was used for behavioral risk factor assessment and physical measurements. Dietary salt intake was estimated from the measurement of sodium (Na) excretion in spot urine samples.The estimated mean dietary salt intake was 7.8 ± 2.5 g/day, and the mean Na/potassium (K) ratio in urine was 4.9 ± 3.4. More than half (54%) of them always took additional salt in their meals, but only 6% of them consumed 5 or more servings of fruits and vegetables per day. A quarter of them perceived salt reduction not at all important. Increased mean salt intakes were marginally associated with lower waist circumference and lower waist-hip ratio. Dietary salt intake among urban slum residents was higher than the recommended level of 5 g/day; however, its association with NCD risk factors was not significant. Further studies are required to identify the urban poor specific factors.

ASSESSING KNOWLEDGE OF HYPERTENSION AND ITS RISK FACTORS AMONG PEOPLE RESIDING IN URBAN AREA IN PASCHIM MIDNAPORE,WEST BENGAL, INDIA

The overall prevalence of raised blood pressure in adults aged 25 and over was around 50% in 2008 Globally. The prevalence is signicantly higher in geriatric population. The number of people with hypertension rose from 600 million in 1980 to nearly 2 billion in 2008. Worldwide, raised blood pressure is estimated to cause 7.5 million deaths, about 12.8% of the total of all annual deaths. This accounts for 57 million DALY (disability adjusted life years)s or 3.7% of total DALYs. Raised blood pressure is a major risk factor for coronary heart disease and ischemic as well as hemorrhagic stroke. Blood pressure levels have been shown to be positively and progressively related to the risk for stroke and coronary heart disease. In some age groups, the risk of cardiovascular disease doubles for each incremental increase of 20/10 mmHg of blood pressure, starting as low as 115/75 mmHg. In addition to coronary heart diseases and stroke, complications of raised blood pressure include heart failure, peripheral vascular disease, renal impairment, retinal hemorrhage and visual impairment. Treating high systolic blood pressure and diastolic blood pressure so they are below 140/90 mmHg is associated with a reduction in cardiovascular complications. Blood pressure can be managed with drugs as well as non-pharmacological measures which consist of exercise, weight reduction, salt restriction, eating fruits and vegetables, etc. Nonpharmacological measures play an important role in management of hypertension. The present study was done to assess knowledge of hypertension and its associated risk factors. Methods:This was a cross-sectional and community-based survey of 500 residents of urban slums in Pascim Midnapore , West bengal, India. Aset of questionnaires assessing knowledge of hypertension and its associated risk factors were used. Results: Most persons (73.6%), possibly due to their negative and neglected attitude towards health promotion.whether having hypertension or not, had average knowledge related to hypertension determinants, diagnosis, management and consequences .Only45% of people knows about the risk factors related to hypertension correctly. Conclusion: It is necessary urgently to promote knowledge, awareness, and health literacy among urban slum residents to prevent hypertension and associated CVDs.