Rural Indian Population Research Articles

Cancer Awareness and Stigma in Rural Assam India: Baseline Survey of the Detect Early and Save Her/Him (DESH) Program.

India has an estimated incidence of more than one million cancers annually. Breast, oral, and cervical cancers account for over one-third of newly diagnosed cases. With the introduction of pilot cancer screening programs in India, little is known about current sociocultural barriers that may hinder acceptance of screening and treatment. We sought to identify knowledge gaps, misconceptions, and stigmas surrounding cancer diagnosis. A baseline survey was conducted in Assam, India, as part of the Detect Early and Save Her/Him program, a mobile screening program for breast, oral, and cervical cancer. Data were collected on participants' cancer knowledge, and attitudes towards screening, diagnosis, and treatment. Of the 923 residents who participated, a large majority (92.9%; n = 858) were neither aware of cancer screening availability nor had prior screening. Low-medium awareness was demonstrated regarding the carcinogenic effects of betel nuts (n = 433, 47%). Only one-third of participants recognized oral ulcers and dysphagia as cancer symptoms. Approximately 10% of respondents had misconceptions about cancer etiologies, and 42-57% endorsed statements reflecting a negative stigma towards cancer, including its long-term detrimental effects on personal, occupational, and familial life. However, the majority (68-96%) agreed with statements endorsing positive community support and medical care for cancer patients. This study identifies actionable targets for intervention in cancer education and awareness within a large rural Indian population. Education to address preventable causes of cancer and to correct misconceptions and stigma is a critical component in ensuring the successful implementation of cancer screening programs.

Measuring catastrophe in paying for healthcare: A comparative methodological approach by using National Sample Survey, India.

Healthcare expenditure significantly varies among various segments of the population. The appropriate measures of catastrophic health expenditure (CHE) will help to unravel the real burden of spending among households. Present study provides a link between the theoretical insights from Grossman's model and various methodological approaches for the estimation of CHE by using data from the three rounds of nationally representative Consumer Expenditure Surveys, India. Statistical analysis has been carried out by using multivariate logistic regression to identify the major determinants of CHE. Findings indicate that the occurrence of CHE has increased during 1993-2012. Rural residents and households with varying age composition such as with higher numbers of children and elderly were at higher risk. Economic status is significantly associated with CHE and increased demand for healthcare. The measurements differ as per the methodological approaches of CHE and definition of household's capacity to pay. Approach-based variations in the results can be of key importance in determining trends and magnitude in CHE. Despite these variations in measurements, study finds a limited incidence of CHE among the disadvantaged segment of the population though a greater share was devoted to health expenditure in recent years. Better risk pooling mechanism is required to address the healthcare needs of the disadvantaged segment such as elderly, children, poor and rural population in India.

Prevalence and association of cardiometabolic risk factors with sociodemographic variables amongst teenagers of rural population of central India

BACKGROUND: The prevalence of the cardio-metabolic risk factors is rapidly increasing amongst the children and adolescents and is a topic of concern due to their induced risk of development of cardiovascular diseases (CVDs) and diabetes mellitus (DM) in adulthood. The aim of this study is to determine the prevalence of the cardio-metabolic risk factors associated with sociodemographic variables amongst the teenagers of rural population in India. METHODS: This cross-sectional study was carried out on 405 teenagers (13-19 years old) in a rural population of central India. The data on the socio-demographic variables and cardio metabolic risk factors were collected using a predesigned proforma. The blood pressure and body mass index (BMI) of the subjects were also recorded. Blood samples were collected for lipid profile and blood sugar. Data was analyzed with the Epi Info software version 6.04. RESULTS: A total of 405 subjects were studied, of whom 182 were male and 223 were female. The prevalence of metabolic syndrome was found to be 9.9% [95% confidence interval (CI): 7.3-13.1]. The prevalence of cardiometabolic risk factors, including low level of high-density lipoprotein cholesterol (HDLC) and impaired fasting glucose (IFG), were found to be 58.3% (95% CI: 53.4-63.0) and 13.8% (95% CI: 10.7-17.5), respectively. 2.2% of the teenagers had a waist circumference (WC) more than the cut off (> 90 th percentile), while high blood pressure was found in 24.40% (95% CI: 18.6-26.7), i.e. > 90 th percentile for age, sex, and height. Similarly, risk factors such as obesity and overweight were found significant (P < 0. 05) in teenagers with family history of obesity. CONCLUSION: Cardiometabolic risk factors is slowly extending to rural areas. Therefore, early detection of these risk factors can be an attempt to prevent or delay the metabolic syndromes, DM, and CVDs.

Know Your Rights: The (un)making of the colonial legal subjects in rural North India, circa 1770–1857

AbstractThis article examines the entanglement of administration, education, and law in North India under early British rule. While there exists extensive discussion on each of these three themes, historians have not paid enough attention to the processes in which, by the mid-nineteenth century, the official minds of the East India Company gradually came to imagine its revenue administration in North India at the institutional intersection of state bureaucracy, village schools, and the law courts. I will argue in this article that through this intersection of knowledge/law-making, the Company wished to foster an ‘enlightened’ but simultaneously obedient subjecthood among the Indian rural population. The contested relationship between the state, the local Indian officials, and the villagers in general, however, thwarted this patronizing ambition.

Self-Rated Oral Health and Associated Factors among an Adult Population in Rural India-An Epidemiological Study.

Background: To determine the perception of oral health status and its associated factors among adults living in rural areas in Karnataka state, India. Methods: A cross-sectional study was conducted among adults in the age group of 35–54 years old residing in villages in a southern state in India. The main outcome measure was poor self-rated oral health (SROH) among adults in rural India. Results: About 873 adults participated in the study. The prevalence of poor SROH was 15.2%. Adults of age 40–44 years, females, those in lower socioeconomic conditions, and those with high caries experience (DMFT ≥ 4) and periodontal disease were associated with poor SROH. Those who had visited a dentist in the previous one year were 1.9 times more likely to report poor oral health. Conclusions: Nearly 15% of rural people reported poor oral health. Socioeconomic conditions, sex, age, smoking, and dental visiting were associated with poor SROH. People’s perception of poor oral health was associated with severe periodontitis and DMFT ≥ 4. A dose–response relationship was observed between experience with dental caries and poor SROH.

Role of Sneha kalpana (Oil based formulation) in the management of Vataja Prameha (Vata predominance Prameha) w.s.r. to Khadira-kramuka kashaya siddha taila

Diabetes mellitus is a fast-growing pandemic. In India, the urban population is more prone to disease rather than the rural Indian population. Dietary habits, faulty lifestyle, and urbanization leading to reduced physical exercise may be responsible to a large extent. Indian system of medicine, namely Ayurveda cited a disease entity named Prameha. It is a clinical syndrome that includes various clinical conditions like, obesity, pre-diabetes, diabetes, and metabolic syndrome. The symptomatology, types, and sub-types mentioned in the context shows relevance with modern times rationale of free fatty acid and its role in peripheral insulin resistance. The article put an emphasis on those cases of chronic diabetes (DM type 2) which becomes insulin dependent in later phase of life and its coherence with Vatolwana prameha of kaphaja and pittaja variety(Kaphaja and Pittajaprameha with predominant Vata). This review article focuses on the Ayurvedic management of chronic insulin dependent type 2 diabetics. Various research papers indexed in Pubmed, SCOPUS, and Web of Science was deeply studied and cited appropriately in the article. The closest possible correlation of modern and Ayurveda principles and their relevance in the present time is tried to be drawn. The treatment protocol given in Ayurveda texts is scientific enough to be taken into consideration for making it as the first-line treatment of not only diabetes mellitus but also in the cases of obesity and metabolic syndrome.

Modeling and assessment of economic viability of grid-connected photovoltaic system for rural electrification

ABSTRACT Renewable energy resources are an adequate substitute for a conventional power system that can deliver greener, consistent quality power with low network congestion and losses. The output of a renewable energy power system effected by the intermittency of resources. The storage system plays a vital role in overcoming intermittency and provides a reliable and smooth power supply to the demand. In the present work, a grid-connected solar PV with a battery storage system is proposed for the rural population in India’s hilly state. The complete resource assessment of the solar system carried out for the grid-connected mode of operation. The total load of the system shared by PV and battery system investigated. Techno-economic analysis and feasibility study carried for the suggested model. The study indicates that the annual saving of a grid-connected system with storage is $3923394.00, with a net present value is $37433.87. The energy cost reduced to $0.21/kWh compared to $0.30/kWh for standalone operation.

Growth of Agricultural Labourers in West Bengal with Special Reference to Uttar Dinajpur District since Independence

Agricultural Labourers from the poorest section of the rural population in India as well as in West Bengal. In numerical terms, they constitute about one-fourth of the total work force. Their number has been rising faster than the rate of growth of rural population. By the term agricultural labourers we mean a person who sells his/her labour power to work to another person’s land for wages in money, kind or a share of the crop. According to the 1991 Census definition, “a person who works on another person’s land for wages – in money, kind or share of crop is regarded as an agricultural labourer. He or she has no risk in cultivation, but merely works on another person’s land for wages. An agricultural labourer has no right of lease or contract on the land on which he or she works”. (Census of India, 1991, paper – III of 1991, p. 6).Thus the Census definition clearly excludes tenants as well as marginal farmers and includes only landless labourers. The definition adopted by us would be broader in the sense that it would include all those for whom sale of labour power in the agricultural sector is a source of livelihood.At the dawn of independence, the economy of West Bengal was characterized not only by a high percentage of landless agricultural labourers in its rural work force but also by a sizeable class of marginal holding peasants. This paper tries to inquire in some detail the causes of the high rate of growth of agricultural labourers in West Bengal as well in the district of Uttar Dinajpur..

'None of my ancestors ever discussed this disease before!' How disease information shapes adaptive capacity of marginalised rural populations in India.

Smallholder farmer and tribal communities are often characterised as marginalised and highly vulnerable to emerging zoonotic diseases due to their relatively poor access to healthcare, worse-off health outcomes, proximity to sources of disease risks, and their social and livelihood organisation. Yet, access to relevant and timely disease information that could strengthen their adaptive capacity remain challenging and poorly characterised in the empirical literature. This paper addresses this gap by exploring the role of disease information in shaping the adaptive capacity of smallholder farmer and tribal groups to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We carried out household surveys (n = 229) and in-depth interviews (n = 25) in two affected districts–Shimoga and Wayanad–in the Western Ghats region.Our findings suggest that, despite the generally limited awareness about KFD, access to disease information improved households’ propensity to implement adaptation strategies relative to households that had no access to it. Of the variety of adaptation strategies implemented, vaccination, avoiding forest visits, wearing of protective clothing and footwear, application of dimethyl phthalate (DMP) oil and income diversification were identified by respondents as important adaptive measures during the outbreak seasons. Even so, we identified significant differences between individuals in exposure to disease information and its contribution to substantive adaptive action. Households reported several barriers to implement adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. We also found that informal information sharing presented a promising avenue from a health extension perspective albeit with trade-offs with potential distortion of the messages through misinformation and/or reporting bias. Altogether, our findings stress the importance of contextualising disease information and implementing interventions in a participatory way that sufficiently addresses the social determinants of health in order to bolster households’ adaptive capacity to KFD and other neglected endemic zoonoses.

A Linkage Between Biomass Fuel Use, Carbon Monoxide Concentration and Housing Policy: A Case in India

This article examines the relationship between the indoor carbon monoxide parts per million (CO-ppm) concentration generated from cooking with biomass fuel and the popular housing policy, Indira Awas Yojana (IAY)/Pradhan Mantri Gramin Awas Yojana of the Government of India that aims at building brick (pucca) houses for a rural population of India. This article is based on a primary survey carried out in two districts of West Bengal, India, covering 360 households. The concentration of CO-ppm in the in-house air was recorded for each surveyed houses at the 10-min interval for an approximately 24-h period using EL-USB-CO data logger (Lascar Electronics, Erie PA, USA). Also, different socio-economic and demographic information was collected using the interview method for each surveyed household. The results indicate positive and significant mean CO-ppm concentration gap for the non-IAY houses over IAY houses over different quantiles of mean CO-ppm distribution. Mean CO-ppm is 4.34 points significantly lower in homes built up under the housing scheme at 50th quantile. The results point out the importance of planned housing and benefit of concrete houses in our survey areas. Housing policies should aim at building a properly designed home with ventilation facilities for minimising CO concentration in dwellings.

Disruptions in oral and nasal microbiota in biomass and tobacco smoke associated chronic obstructive pulmonary disease.

Chronic exposures to tobacco and biomass smoke are the most prevalent risk factors for COPD development. Although microbial diversity in tobacco smoke-associated COPD (TSCOPD) has been investigated, microbiota in biomass smoke-associated COPD (BMSCOPD) is still unexplored. We aimed to compare the nasal and oral microbiota between healthy, TSCOPD, and BMSCOPD subjects from a rural population in India. Nasal swabs and oral washings were collected from healthy (n = 10), TSCOPD (n = 11), and BMSCOPD (n = 10) subjects. The downstream analysis was performed using QIIME pipeline (v1.9). In nasal and oral microbiota no overall differences were noted, but there were key taxa that had differential abundance in either Healthy vs COPD and/or TSCOPD vs. BMSCOPD. Genera such as Actinomyces, Actinobacillus, Megasphaera, Selenomonas, and Corynebacterium were significantly higher in COPD subjects. This study suggests that microbial community undergoes dysbiosis which may further contribute to the progression of disease. Thus, it is important to identify etiological agents for such a polymicrobial alterations which contribute highly to the disease manifestation.

Data on periodontal health among elderly people in Bushland, Jharkhand, Magadha and Patna, India.

It is of interest to report data on periodontal Health among elderly people in Bushland, Jharkhand, Magadha and Patna, India. The sample comprised of a 130 elderly people. The studies device comprised of a semi-structured survey with thirteen questions. Data shows that old people in Jharkhand suffered from advanced periodontal ailment (47.6%) with easy gingivitis (33.8%). Data also shows that grownups (88.2% grownup males, 64.5% girls in Jharkhand and 34.5% grownup males and 88.9% girls in Bihar) used toothpaste and toothbrush as their primary style for tooth cleansing. These data help in providing improved dental service to rural population in India.

Prevalence and risk factors of gastroesophageal reflux disease in a rural Indian population.

Studies on frequency and risk factors of gastroesophageal reflux disease (GERD) in the rural Indian population are scanty. This household survey was undertaken by the trained interviewers in the adult population (≥ 18 years) in four villages in northern India using translated-validated Enhanced Asian Rome III and hospital anxiety and depression questionnaires. Of 2774 subjects, 2019 (72.8%) had no heartburn. Heartburn frequency was as follows: 314 (11.3%) once/week, 143 (5.2%) twice/week, 85 (3.1%) thrice/week, 69 (2.5%) four times/week, 48 (1.7%) five times/week, 18 (0.6%) six times/week, 41 (1.5%) daily, 37 (1.4%) > once daily. A total of 298 (10.7%) had GERD (definition: heartburn > twice/week). Older age (36.5 vs. 35 years), non-Hindu religion (7, 2.4% vs. 30, 1.2%), lower education (127, 42.6% vs. 789, 31.9%), lower socioeconomic class (94, 31.5% vs. 517, 20.9%) and income (below Indian National Rupees [INR] 458; 105, 35.2% vs. 599, 24.2%), non-vegetarian diet (15, 5% vs. 105, 4.2%), intake of tea/coffee (260, 87.2% vs. 1687, 68.1%), carbonated soft drinks (216, 72.5% vs. 1234, 49.8%), and alcohol (48, 16.1% vs. 313, 12.6%), tobacco chewing (116, 38.9% vs. 681, 27.5%), and smoking (105, 35.2% vs. 672, 27.1%) were associated with GERD on univariate analysis. On multivariate analysis, body mass index > 25 kg/m2 (odds ratio [OR] 1.23; 95% CI 0.88-1.71), predominant rice eating (1.13; 0.74-1.74), tobacco chewing and smoking (1.68; 1.24-2.30 and 1.36; 0.99-1.88), and alcohol (1.2; 0.78-1.83) and carbonated soft drinks (2.48; 1.79-3.44) intake were associated with GERD. A total of 122 (41%) had associated functional dyspepsia. Psychological comorbidities were commoner among those with than withoutGERD. In this rural Indian population, 10.7% had GERD and predominant rice eating, tobacco chewing, and carbonated soft drink intake were the risk factors. Psychological comorbidities were common.

Incidence of Non-Traumatic Subconjunctival Hemorrhage in an Indian Rural Population.

PurposeTo determine the incidence of non-traumatic subconjunctival hemorrhage (NTSH) in Indian rural population and analyze the associated risk factors.MethodsThe study included patients diagnosed having subconjunctival hemorrhage (SCH) who attended the out-patient department (OPD) of ophthalmology. Demographic characteristics of subjects included age, gender, medical and ocular history, and location of hemorrhage.ResultsThe incidence rate of NTSH in this study was 3.07 per 1000 patients per year attending OPD. The men to women ratio for NTSH was 1.26 (95% CI). The commonest site of presentation was nasal side (n=36, 51.4%). Right eye (n= 37, 54.3%) was affected more than the left eye (n=28, 40%). The analysis showed 24 patients (34.3%) did not have any etiological factor attributable to SCH. Conjunctivochalasis (CCH) was associated in 15 patients (21.4%). An antiplatelet agent was associated with SCH in 7 patients (10%). Other factors associated with SCH were hypertension, leukemia, and anemia (n=6, 8.6%).ConclusionThis study indicates that NTSH occurs in 3 out of 1000 individuals per year in the rural population presenting to the OPD. Nasal conjunctiva was commonly involved. CCH was associated with 15 patients. Use of antiplatelet agents, hypertension and blood disorders are associated with the risk of NTSH. Patients presenting for the first time with NTSH should be screened for systemic etiological factors.

The prevalence of depression among the elderly people living in rural Wardha.

Background:Depression is the most common psychiatric disorder among elderly population in India, which generally remains undiagnosed and undertreated. Exact burden of depression among the elderly population in rural India was not known.Aim:This study was conducted to determine the prevalence of depression among the elderly population in rural population of Wardha, Maharashtra.Materials and Methods:This is a cross-sectional study carried out among the elderly (≥60 years) population of both sexes residing in the field practice area of the department of community medicine. Geriatric depression scale was used for screening depression among the study population. Data collection was completed within 2 months using convenience sampling. Ethical approval was taken before beginning the study. Magnitude was expressed in percentage along with its 95% confidence interval (CI). Univariate and multivariate logistic regressions were done. Odds ratio and 95% CI were used to express association.Results:Magnitude of depression among the elderly population was found to be 41.7% (95% CI: 36.1–47.4). In this study, we found the following factors to have positively contributed towards depression among elderly population in rural Wardha: female sex, widowed, separated, divorced, decreased decision-making capability, abused, or being suffering from chronic illnesses.Conclusion:Our study showed the prevalence of mild depression to be 26.72% and that of severe depression to be 15.17% among the elderly study participants.

Assessment of the correlation between the perceived, desired, and normatively determined orthodontic treatment needs in a rural population of India

Background: The perception about what constitutes a pleasing smile varies from person to person. The problem of crooked teeth may not be perceived as an actual need for treatment by some, and may differ not only on an individual basis, but also from a geographic perspective. Aim: The aim of the study was to assess if orthodontic treatment needs correlated with the actual self-perception and desire for orthodontic treatment in a rural population and was there an influence of gender and age. Materials and Methods: The study population included 495 older adolescents and younger adults between the age group of 16–24 years, randomly selected from villages in Dehradun. They were asked about their desire for orthodontic treatment and evaluated through the esthetic component of Index of Orthodontic Treatment Need (IOTN-AC) and the Dental Aesthetic Index (DAI). Bivariate analyses using the Chi-square test were performed (SPSS software [version 17.0]) to test the influence of age and gender on desired, perceived, and normative needs. Associations between the different needs were tested using both simple and multiple logistic regression analysis. P

Reproductive Performance Trends among Villagers of Birsingha Gram, Ghatal under Midnapore District, in West Bengal, India

Health is considered to be the most significant factor that triggers building of a nation. Factors related to health are the prime concern of research for medical and social researchers. The status of health among the rural population of India needs attention, and under this backdrop the present study has aimed at exploring the reproductive performance among villagers of Birsingha Gram, Ghatal under Midnapore District, in West Bengal, India. We tried to understand some of the determinants of reproductive health such as: Age at menarche, marriage, conception and childbirth as well as desired no. of children, gender preference and other health care practices. All these factors affect women’s reproductive health, which in turn affects the wellbeing of their families and overall economic growth of the nation. A total of 300 responses were taken into consideration for the present study.

Assessment of sleep quality and quality of life in hypertensive subjects at a tertiary care hospital in Uttarakhand, India

Background:Hypertension is a leading risk factor for cardiovascular diseases with prevalence of 33% in urban and 25% in rural population in India. Studies have suggested that hypertension significantly affects the sleep quality and quality of life of subjects. Therefore, this study aimed to establish a correlation between sleep quality, quality of life, and hypertension in Uttarakhand.Methods:This observational cross-sectional study was carried out on hypertensive subjects at a tertiary care hospital in Uttarakhand following ethics approval. After taking consent from participants, blood pressure and anthropometric measurements were recorded. Then, their sleep quality and quality of life was assessed using Pittsburgh sleep quality index (PSQI) and WHO-QOL BREF questionnaire respectively. Statistical analysis was then carried out to correlate these parameters.Results:168 participants were recruited for this study, with 43.5% males and 56.5% females. It was found that 77.4% of these subjects were having poor sleep quality with the mean global PSQI score as 7.90 ± 3.713. These subjects assessed their Quality of life to be worst in physical domain (12.68 ± 3.13), followed by psychological, social relationship domain and environment domain. A significant association was found between sleep quality and different stages of hypertension (P value = 0.039) but quality of life and stages of hypertension have no significant association (P value > 0.05).Conclusions:Sleep quality, quality of life and blood pressure are correlated. So, clinicians should also focus on improving their patient's sleep quality and quality of life besides pharmacological treatment.

Effect of Maternal Anaemia on Different Macronutrients of Breast Milk in the Rural Population of India: An Observational Cross-sectional Study

Introduction: Anaemia during pregnancy is a major public health problem throughout the world, particularly the developing countries. Maternal anaemia affects the major macronutrients contents of breast milk. Aim: To analyse the major nutrients and components of transitional milk in anaemic mothers and healthy non anaemic mothers. Materials and Methods: This was an observational crosssectional study conducted from January 2018 to June 2019 for a period of 18 months, included 180 lactating mothers who were divided into two groups: Anaemic {Haemoglobin (Hb) &lt;11 gm/dL} and Non anaemic (Hb &gt;11 gm/dL) based on their antenatal haemoglobin status. Anaemic group patients were further subdivided according to severity as recommended by the Indian Council of Medical Research. Breast milk samples (15-20 mL) were collected from postpartum patients on day 4 to 14. The sample was collected in the morning 1 hour after the previous breastfeeding and instilled into a milk analyser and compared the following major components (fat, lactose, protein) in both the groups. The data was coded in Microsoft excel sheet and was analysed by using Statistical Package for the Social Sciences (SPSS) version 24.0 software. Analysis of the component of transitional milk was done. Results: There were 90 cases in each group, with total 180 lactating mothers. The mean age of the anaemic group was 26.18±2.89 and non anaemic group was 26.03±3.43 (p-value= 0.792) were statistically similar. The mean parity of both the group (p-value=0.039) were significant. Study shows that anaemia grossly affects the protein and lactose content of the breast milk but there is no significant change in fat content. In severe anaemia, there was significant difference present in all the 3 components, fat, protein, and lactose (p-value=0.012, p-value=0.051, p-value=0.001 respectively). Conclusion: Maternal anaemia particularly of severe type adversely affects all the macronutrients of breast milk in terms of protein, fat, and lactose.

Effect of Maternal Anaemia on Different Macronutrients of Breast Milk in the Rural Population of India: An Observational Cross-sectional Study

Effect of Maternal Anaemia on Different Macronutrients of Breast Milk in the Rural Population of India: An Observational Cross-sectional Study