Rural West Bengal Research Articles

SCRUB TYPHUS IN CHILDREN: A RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL OF RURAL WEST BENGAL, INDIA

Scrub typhus is an emerging acute undifferentiated febrile illness (AUFI) among children, particularly in rural West Bengal. Due to the lack of gold standard diagnostic tests, and lack of awareness among healthcare personnel, it leads to delay in diagnosis and specic treatment which leads to several complications and even death. In this perspective, with the hope to know better, this study was done to evaluate clinical features, complications, laboratory proles and outcome of scrub typhus in the paediatric population. AIMS AND OBJECTIVES:To study clinical features, complications, laboratory proles and outcomes of scrub typhus in children. MATERIALANDMETHODS:Thisretrospective studywas conducted in theDepartment ofPaediatrics ofBankuraSammilaniMedicalCollege and Hospital(BSMCH),Bankura,India.Data of 75 childrenwhowere found to be IgMpositive toOrientia tsutsugamushi, aged onemonth to 12 yearswere collectedfromthe case registermaintainedinourunitfromJune2020toAugust2021andwere analysedbyEpiInfo,version3.5.1,software. RESULTS: Fever was the most common presenting symptoms seen in 100% (n=75) of cases. Other common signs and symptoms were vomiting (n=22,29.3%), pain abdomen (n=15,20%), cough(n=22,29.3%), myalgia (n=12,16%), headache (n=12,16%), convulsions (n=8,10.7%), pallor (n=25,33.3%), facial pufness (n=28,37.3%), oedema (n=12,16%), eschar (n=20,26.7%), hepatomegaly (n=45,60%) and splenomegaly (n=42,56%). Among laboratory parameters, anaemia (n=72,96%), leucocytosis (n=31,41.3%), thrombocytopenia (n=43,57.3%), raised alanine aminotransferase (n=49,65.3%), aspartate aminotransferase (n=46,61.3%) and hypoalbuminemia (n=31,41.3%) were observed. Meningoencephalitis was present in 10.7% (n=8) of cases. CONCLUSION: A high index of suspicion and abnormal laboratory ndings will help physicians in the timely diagnosis of scrub typhus and initiate anti-scrub treatment early, thereby preventing complications and minimising fatality.

Magnitude of hypothyroidism among patients of cholelithiasis in a tertiary care centre in rural West Bengal: a prospective study

Background: Cholelithiasis is a common pathology of the gall bladder affecting about 10 to 15% of the adults in western countries and 2 to 29% in India. More than 80% of the patients with cholelithiasis are asymptomatic. Hypothyroidism may cause gall stone formation due to the hyperlipidemia, motility disorders affecting the bile duct and sphincter of Oddi.Methods: This was a descriptive cross-sectional study conducted at Department of Surgery, Bankura Sammilani Medical College and Hospital, Bankura from March 2019 to February 2020 for duration of one and half year. The sample size was 54 and consecutive non-probability sampling technique was used for the sampling. All the collected data were recorded in a pre-designed proforma and analyzed in MS excel.Results: Out of 54-patients with cholelithiasis, 28% patients were from the age group 45-54 years.40% patients were hypothyroid pre-dominantly females. Among 30-female patients 11 (26.82%) were hypothyroid and among 11-male patients 2 (15.38%) were hypothyroid. Hypothyroidism in male and female was statistically significant.Conclusions: This study was introduced to determine the relationship between hypothyroidism and cholelithiasis. It was concluded that hypothyroidism was more common in female, obese and elder patients. The gender distribution of the hypothyroidism in patients with cholelithiasis was statistically significant while all other variables were statistically not significant.

Choice of Place of Delivery during COVID-19 Pandemic: Observation from a Community-Based Survey in Rural India

For the past two decades, India has made considerable improvement in health indicators and the country was on the right track toward achieving sustainable development goal-3 by 2030. However, the COVID-19 pandemic has disrupted the health-care system including the essential health services for mother and child. This study was carried out to understand the barriers for utilization of institutional delivery and its prevalence during the pandemic in rural West Bengal. A total of 318 number of women from 18 sampled villages of Canning II block of South 24 Parganas district were interviewed face to face using a semi-structured interview schedule between October and November 2020. The data were analyzed using Stata and NVivo 12 Pro software. Findings show that more than one-fourth (27.3%) of the deliveries took place at home without any assistance of medical professionals. Fear and anxiety related to COVID-19, uncertain service availability, poor service quality during the pandemic, and lack of supporting hands at households compelled women to choose home delivery instead of institutional delivery. Those delivered at institutions, many of them were released on the day of delivery itself, which resulted poor perinatal care even in the cases of institutional delivery. The findings recommend that in addition to COVID-19 related health services, essential maternal and child health services should be continued with the quality to achieve Sustainable Development Goal 3.

Estimation of Nitrogen Dioxide (NO2) due to Burning of Household Biomass Fuel and Assessment of Health Risk among Women in Rural West Bengal

More than 75% population living in rural sectors in India and mostly rely on biomass fuels due to their easy availability. Here in this study we examined the health risk from the smoke emitted due burning of biomass fuels while cooking in rural houses in West Bengal. Out of numerous gaseous pollutant this study selected NO2 component to find out the health risk of women. NO2 has been monitored in kitchen and adjacent living room in N= 30 households in three season namely summer, monsoon and winter, respectively. Study results found that highest NO2 concentration found in kitchen room than in living room in all seasons and the difference between the concentrations showed significant results (< 0.001). However, ANOVA analysis has been done to check the seasonal variation within the kitchen and living room NO2 concentrations and results have revealed that there was significant (< 0.001) difference present within kitchen and living room concentration seasonally. Moreover, women health risk were assessed with established empirical model. Results showedthathere were no immediate acute health risk present among women whereas women possessed chronic health risk (HQ > 1) from kitchen room NO2 concentration. This study concluded that NO2 has chronic health effects on women who habituated to continue cooking with unprocessed biomass fuels. Study also suggested to use more clean fuel like LPG, electric and solar energy for daily use and in this respect PMUY is doing a significant work.

Significance of the Microcredit Delivery Models for Livelihood Upgradation: A Comparison Between SHGs–Bank Linkage Model and Micro Finance Institutions Model with Case Studies from Rural West Bengal, India

Microfinance is seen as a useful way to alleviate the financial problem of the rural poor. In India, SHG bank linkage (SBL) programme and the Microfinance institution (MFI) are two main sources of microcredit. This article aims to compare the importance of the credit delivery processes under these two types of microfinancing approaches in ordering the livelihood of the recipients. For this purpose, a set of indicators are chosen from different domains of livelihood. Information is collected through a primary survey in some selective villages of West Bengal, India and is analysed using different statistical techniques. It is found that the MFI recipients experience better impact than SBL recipients though the SBL’s recipients have greater improvement in cases of savings habit, mobility, and access to the health. Besides, the number of loans received and the mode of utilisation of the credit are observed as the most significant factors influencing the livelihood outcome in both cases.

PROJECTION OF NEW CANCER CASES IN THE STATE OF WEST BENGAL, INDIA - 2020: Estimated district wise new cancer cases in West Bengal-2020

It is essential to project cancer incidence for planning cancer control actions, health care and allocation of resources in specific region. Till date no projection of cancer cases according to primary sites and district wise distribution of the cancer cases for the state of West Bengal are available in the literature. In West Bengal only one Population Based Cancer Registry (PBCR) for Kolkata is ongoing cancer registration in West Bengal which is based on urban population only but there is no Population Based Cancer Registry (PBCR) for rural West Bengal Kolkata. PBCR is helpful for the projection of cancer cases in any region. Here the cancer burden for the state of West Bengal had been made to understand the magnitude of cancer problem for the calendar year 2020. The age, sex, primary site and district-wise cancer incidences were projected on the basis of data along with populations covered by the PBCRs obtained from the report of National Cancer Registry Programme (NCRP) published by National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR) for the period 2005-2014. Thus pooled age-sex specific cancer incidence rates for urban area were obtained by taking weighted averages of 18 PBCRs of India based on exclusively urban population with respective registry populations as weights. Pooled age sex specific cancer incidence rates for rural area were obtained by taking weighted averages of 15 PBCRs of India based on rural, district and state population with respective registry populations as weights. The pooled incidence rates were assumed to represent the incidence rates for the state of West Bengal. Populations of this state according to age and sex exposed to the risk of development of cancer in 2020 were obtained from the report of Registrar General of India providing population projections for the state for 2020. Population forecasts were combined with the pooled incidence rates to estimate the projected number of cancer cases by age, sex and site of cancer for 2020. The projections were carried out for the various leading sites as well as for ‘all sites’ of cancer. The leading site of cancers, namely those of tobacco related cancers, breast and cervical cancers in women account for over 50 to 60 % of all cancers. Adjustments were made for increasing tobacco habits, exposure to arsenic, Gangetic delta region and also adjustments for increasing trends of lung, prostate, mouth, tongue, and larynx in males and that for breast, cervix uteri, ovary, gall bladder and lung in females were made, the estimates may further increase. The main factors contributing to high burden of cancer over the years are increase in the population size as well as increase in proportion of elderly population, urbanization, Gangetic delta and arsenic exposure. This projection of cancer incidence will help the policy planners for strengthening and augmenting the existing diagnostic/treatment facilities. Also it will help the researchers to plan their research activities in the field of cancer. Keywords: Projection - Cancer incidence - Magnitude of cancer –District wise– West Bengal

What are the challenges for antibiotic stewardship at the community level? An analysis of the drivers of antibiotic provision by informal healthcare providers in rural India.

In many low- and middle-income countries, providers without formal training are an important source of antibiotics, but may provide these inappropriately, contributing to the rising burden of drug resistant infections. Informal providers (IPs) who practise allopathic medicine are part of India's pluralistic health system legacy. They outnumber formal providers but operate in a policy environment of unclear legitimacy, creating unique challenges for antibiotic stewardship. Using a systems approach we analysed the multiple intrinsic (provider specific) and extrinsic (community, health and regulatory system and pharmaceutical industry) drivers of antibiotic provision by IPs in rural West Bengal, to inform the design of community stewardship interventions. We surveyed 291 IPs in randomly selected village clusters in two contrasting districts and conducted in-depth interviews with 30 IPs and 17 key informants including pharmaceutical sales representatives, managers and wholesalers/retailers; medically qualified private and public doctors and health and regulatory officials. Eight focus group discussions were conducted with community members. We found a mosaic or bricolage of informal practices conducted by IPs, qualified doctors and industry stakeholders that sustained private enterprise and supplemented the weak public health sector. IPs' intrinsic drivers included misconceptions about the therapeutic necessity of antibiotics, and direct and indirect economic benefits, though antibiotics were not the most profitable category of drug sales. Private doctors were a key source of IPs' learning, often in exchange for referrals. IPs constituted a substantial market for local and global pharmaceutical companies that adopted aggressive business strategies to exploit less-saturated rural markets. Paradoxically, the top-down nature of regulations produced a regulatory impasse wherein regulators were reluctant to enforce heavy sanctions for illegal sales, fearing an adverse impact on rural healthcare, but could not implement enabling strategies to improve antibiotic provision due to legal barriers. We discuss the implications for a multi-stakeholder antibiotic stewardship strategy in this setting.

Managing mobility: commuting domestic workers, mobile phones, and women’s ‘honour’ in Kolkata

ABSTRACT Drawing on ethnographic fieldwork in Kolkata and rural West Bengal and engaging with literature on mobile phones in the global South, and on gender and sexuality in India, this article seeks to understand the incongruence between widespread mobile phone use in India and commuting domestic workers’ own accounts of their mobile phone use. It illustrates the important role that mobile phones play in enabling commuting workers (who are mostly women) to find work and manage relationships, but also how commuting workers play down their mobile phone use, guarding against suspicion from husbands, sons, and others. Such suspicion reflects the stigma around women’s mobility/sexuality, connected to ideas about women’s ‘honour’ and the perceived risks associated with women’s work and journeys. When workers’ mobile phone use is, then, perceived to be ‘inappropriate’, or if workers transgress norms and expectations relating to ideas about women’s ‘honour’ in other ways, they can face (further) surveillance and abuse, their access to phones thereafter often being controlled by men. Contributing to gendered analyses of mobile phones in the global South, the article shows how phones can at once create new possibilities and freedoms for commuting domestic workers while at the same time reinforcing gendered power relationships.

Electrocoagulation for Arsenic Removal: Field Trials in Rural West Bengal.

Arsenic contamination in drinking water is a great concern in different regions of the world as well as in India. Several technologies have been investigated to remove arsenic from water, such as coagulation and co-precipitation, ion exchange, adsorption, and reverse osmosis. In the present research, electrocoagulation with iron electrodes has been assessed as a treatment technology for arsenic removal from groundwater to reach concentrations below 0.01mg/L (WHO limit) and which is technically effective, affordable for the local area, and easy to operate and maintain. Electrochemically generated iron is converted to hydrated ferric oxide within the contaminated water, which takes up the arsenic from water. A downstream filtration unit (sand or activated alumina) is applied to remove ferric hydroxide flocs produced during the process. The laboratory experiments were conducted in a batch reactor using iron plates as electrodes with monopolar configuration to study the effects of initial pH and electro-charge loading (ECL) on arsenic removal. The optimum operating condition was observed for an electro-charge loading of 25-30 Coulombs/L at pH 7.0 and an initial arsenic concentration of 0.2mg/L. Two field trials were implemented in West Bengal after suitably designing the electrocoagulation system. Arsenic removal was significant (75-80%) delivering safe water with arsenic below 0.01mg/L (acceptable limit). Passivation of the electrodes occurred during the operation and calcium-based (including iron) deposition was observed on the cathodes. Passivation is avoidable after running regular polarity reversal of the electrodes.

A Survey to Assess the Knowledge, Attitude and Practice about COVID-19 Pandemic from West Bengal, India

Introduction: The Coronavirus Disease-2019 (COVID-19) that originated in China in December 2019 was declared a pandemic by the World Health Organisation (WHO) on 11th March, 2020. It has resulted in extensive lockdown measures in India and in the state of West Bengal. Both Central and State Governments have made considerable efforts to increase awareness about the pandemic among the general public. Aim: This study was conducted to assess the Knowledge, Attitude, and Practice (KAP) among the general public of West Bengal about the pandemic as no such data is available till date. Materials and Methods: The retrospective survey was undertaken among the general public of the state of West Bengal, India, by means of social media platforms (Facebook, Instagram and WhatsApp) through a validated e-questionnaire containing 10 questions during 18th April, 2020 to 3rd May, 2020. Data was captured on Google Forms, which were analysed using appropriate tools. Results: A total of 355 responses were obtained. A 97% of responders were completely aware of the pandemic with 92% practising preventive measures, such as social distancing, washing hands, and wearing a mask. Majority of the participants were young (18-30 years of age) with 51% being males. A 99% of the responders were literate and 86% were from urban dwelling. Total 61% of the participants stated that they have learnt something new after participating in this survey. Conclusion: KAP about COVID-19 pandemic was found to be high in the general population of West Bengal. Involvement of various social media platforms is required for generating mass awareness about COVID-19 in rural West Bengal. Continuous communication and survey by the Government is necessary to spread public awareness as information about COVID-19 is constantly evolving.

Determinants of Treatment Adherence Among Patients Living With Noncommunicable Diseases: A Mixed-Method Study in a Rural Area of West Bengal.

The multisectoral impact of the COVID-19 pandemic can impair treatment adherence of patients with noncommunicable diseases (NCDs). This mixed-method study, conducted from November 2020 to January 2021, assessed the quantum of their treatment adherence and its determinants in rural West Bengal. Quantitative data were collected from 213 NCD patients while qualitative exploration for barriers of treatment adherence was conducted as 6 in-depth Interviews. Treatment adherence was assessed by “Medication Compliance Questionnaire” and “Adherence to Healthy Lifestyle and Follow-up Advice” Questionnaire. A total of 39.4% were nonadherent to medications while 67.1% had nonadherence to healthy lifestyle and follow-up advice. Significant predictors associated with nonadherence were increasing age, female gender, lower socioeconomic status, decreasing patient empowerment, and decreasing trust in the medical profession. Economic crisis, fear of contagion, and nonavailability of investigation facilities were some new emerging barriers in addition to preexisting barriers of treatment adherence. Therefore, measures for improving patient empowerment and patient–provider relationship by motivation and counseling, taking proper care of vulnerable patients affected by the pandemic, and correcting deficiencies at the health-system level should be given utmost priority.

The All India Ophthalmological Society - Academic and Research Committee pan-India diabetic retinopathy project "Fixing the missing link": Prevalence data from West Bengal.

Purpose:The aim of this study was to determine the prevalence of diabetic retinopathy (DR) and its risk factors among diabetic patients in rural and urban West Bengal (WB).Methods:Patients were screened in the physician's clinic by a team of ophthalmologist, optometrist and counsellor. Demographic details, diabetic control, compliance to eye checkup, awareness regarding diabetic blindness, and visual acuity were recorded using a questionnaire. DR was graded both by indirect ophthalmoscopy and fundus photo taken with a portable fundus camera.Results:A total of 1553 subjects were screened over 39 camps across 14 districts of WB over 17 months. The prevalence of DR was 21.51%, with a significant difference between rural (26.55%) and urban (13.89%) areas (P < 0.01). No significant difference with gender was seen (P = 0.99). Presence and grade of DR were related to age, loss of vision, diabetic age, diabetic control, awareness of diabetic blindness and last eye checkup.Conclusion:This study provides the first major prevalence data from WB, and gives valuable insight regarding modifiable risk factors for DR. It is also the first DR study in India to be conducted in the physician's clinic. The study results emphasise the need to “fix the missing link” between ophthalmologists and treating physicians to win the battle against DR.

The Gift of Solidarity: Women Navigating Jewellery Work and Patriarchal Norms in Rural West Bengal, India

In the context of declining women’s participation in the formal economy in India, this article looks at how women’s work in the informal sector of jewellery-making emerges as a gift. Gendered discourses on work turn men, who worked as labourers, into supervisors who monitor and control work situations and sort and grade final products in jewellery workshops. Following Anna Tsing, I argue that jewellery products start their lives as gifts but as they move from women (who are seen as housewives and family members) to men (who are seen as professionals/experts within the workshop) and beyond, they become commodities. This journey from gift to commodity within the workshop is made possible by a gendered discourse on work and by the dynamics within small landholding middle-caste households. Further, I underscore that women’s informal networks often help them cope with the emotional and affective tensions of work and the demands imposed on them by the men and their own households. Women facilitate the transition from gift to commodity by colluding amongst themselves to work in these informal spaces to maintain household status within peri-urban villages of West Bengal.

Digital access through smartphones and well-being of BoP women: insights from a field study in India

PurposeThe authors study the effect of access to smartphones on the socio-economic well-being in the case of rural base of the pyramid (BoP) women. While smartphone access may have its benefits, the paper suggests augmenting access with a sociotechnical intermediary (STI) that facilitates training and online community building to enhance the well-being outcomes.Design/methodology/approachThe authors conducted a survey from three groups of women from rural West Bengal (India) – (1) who do not own smartphones, (2) who have their own smartphones and (3) who receive smartphones and STI support (over two years). The authors evaluate the effect of access to smartphones and STI support on social well-being (including structural social capital and empowerment) and economic well-being (including entrepreneurial intent and subjective economic well-being).FindingsThe analysis results suggest a high relationship between smartphone ownership and higher structural social capital, empowerment (in terms of freedom of movement) and entrepreneurial intent. The authors further find these effects to be enhanced amongst women who received smartphones and support from STI.Originality/valueThe authors attribute this enhanced well-being amongst women with smartphones and STI support to peer-learning and cultivation of virtual role models facilitated by the STI through creation of intra-community online groups. The results have significant policy implications for socio-economic well-being of rural BoP women.

Fuzzy Logic and Statistical Based Modelling to Predict Rural Solid Waste Generation of West Bengal

Waste generation prediction is a vital component to planning of rural solid waste management. Based on the past statistical data mathematical model can be develop but incorporation of new data cannot be done. In this situation advance model need to be developed, which can predict. Fuzzy logic may be one option for develop such model because dynamic and linguistic date can be used as an input parameter. A mathematical model has been developed to predicting the total. Rural waste generation using fuzzy logic if west Bengal study area. House hold, population, per capita income, district wise domestic product, literacy rate were considered as an independent variable for predicting rural solid waste generation. To described the dependent and independent variable triangular and trapezoidal shaped membership function are used. To described the defuzzification centroid method has been applied. Initially two input variables have been used to identify the correlation with rural solid waste generation Finally all input variable considered for the mathematical model. Per-capita waste generation in rural west Bengal average 150 to 300 gm/day. The statistical analysis rebuilds that age group wise population and income model is the best fitted model.

Population-level effective coverage of adolescent weekly iron and folic acid supplementation is low in rural West Bengal, India.

To assess the coverage of the adolescent weekly iron and folic acid supplementation (WIFS) programme in rural West Bengal, India. We conducted a population-based cross-sectional survey of intended WIFS programme beneficiaries (in-school adolescent girls and boys and out-of-school adolescent girls). Birbhum Health and Demographic Surveillance System. A total of 4448 adolescents 10-19 years of age participated in the study. The percentage of adolescents who reported taking four WIFS tablets during the last month as intended by the national programme was 9·4 % among in-school girls, 7·1 % for in-school boys and 2·3 % for out-of-school girls. The low effective coverage was due to the combination of large deficits in WIFS provision and poor adherence. A large proportion of adolescents reported they were not provided any WIFS tablets in the last month: 61·7 % of in-school girls, 73·3 % of in-school boys and 97·1 % of out-of-school girls. In terms of adherence, only 41·6 % of in-school girls, 38·1 % of in-school boys and 47·4 % of out-of-school girls reported that they consumed all WIFS tablets they received. Counselling from teachers, administrators and school staff was the primary reason adolescents reported taking WIFS tablets, whereas the major reasons for non-adherence were lack of perceived benefit, peer suggestion not to take WIFS and a reported history of side effects. The effective coverage of the WIFS programme for in-school adolescents and out-of-school adolescent girls is low in rural Birbhum. Integrated supply- and demand-side strategies appear to be necessary to increase the effective coverage and potential benefits of the WIFS programme.

Concomitants of Gynaecological Problem: A Study on Young Married Women of Rural West Bengal

Gynaecological problem makes up a sizable proportion of disease burden in women. Majority of these problems remain unaddressed as cultural and gender norms make women silent to report these problems. Undiagnosed and untreated gynaecological problems at young age may have physical and psychological consequences in later life. This article aims to understand the prevalence of gynaecological problems and its concomitants among young married women of rural West Bengal. We collected data on 1,107 young married women, aged 24 years or below, inhabiting the rural areas of three districts of West Bengal with at least one child of five years or below. A pretested structured schedule was used to collect data on socio-demographic variables and symptoms related to gynaecological problems and their management. Focus group discussions (FGDs) were conducted to get an in-depth understanding of the participants towards gynaecological problems and management. Around 41 per cent of women reported at least one of the gynaecological problems. Excessive vaginal discharge with bad odour, pain or burning sensation while passing urine, itching at vagina, lower abdominal pain, menstrual irregularities and painful menstruation were the most reported problems. Only 22 per cent of participants sought medical advice. FGDs reveal that there is a variation among the participants regarding the perception and awareness of gynaecological problems. Sexual activity, early marriage and menstrual hygiene were perceived to be the causes of gynaecological problems. The local healers were consulted at the initial stage of the problem; qualified medical practitioners were consulted when the problem persisted. We conclude from this study that socio-cultural factors remain the primary reason behind the high prevalence of gynaecological problem among the study participants.

Implementing Vetiver grass-based riverbank protection programmes in rural West Bengal, India

The largely impoverished rural communities of India are unable to bear the costs involved in creating and maintaining substantial structural measures for riverbank protection. The monsoonal nature of the country’s streams and an agrarian economy based on intensive cultivation further heighten the risk posed by annual peak flows and shifting stream courses. Mitigating this requires urgent, sustainable and cost-effective means of conserving valuable farmlands and stabilising channel boundaries. Towards this, riverbank erosion mitigation using Vetiver grass has been a recent development in the country and has been experimented with in a few areas. In this article, we examine how such riparian buffers are created through riverbank modification, planted and nurtured and the effectiveness of the grass in mitigating erosion, taking a small case study from rural West Bengal as an example. We especially focus on the government policies and frameworks and local stakeholder involvements that facilitate such an undertaking, with particular emphasis on the organisational workflow and the ground-level perception of such endeavours, as these are crucial to the success and effectiveness of such schemes. The marked successes achieved through the use of the Vetiver grass in abating erosion and the hindrances encountered in implementing such mitigation projects are outlined, along with the importance of such community-based approaches to river management and monitoring. This case study can be a microcosm for similar such endeavours, particularly in the rural global south.

Validation of the World Health Organisation 5-Item Well- Being Index (WHO-5) among the Adult Population Living in a Chronically Arsenic Affected Area of Rural West Bengal in India

Objective: The aim of this study was to validate the World Health Organisation 5-item well-being index(WHO-5) in a sample of the adult population living in a chronically Arsenic affected area in rural WestBengal.Materials and Method: The reliability was measured through Cronbach’s alpha. For evaluating the validityof the construct, Barlett sphericity test and the Kaiser-Meyer-Olkin sample adequacy test was conducted.Exploratory factor analysis was done to study the dimension of factors. Correlations were explored betweenthe WHO-5 scores and study variables.Results: The mean score of the total WHO-5 score was 13.09(SD=5.276). A Cronbach’s alpha of 0.794indicated acceptable internal consistency. The Bartlett’s Test of Sphericity was significant (Chi =167.86,df=10, p&lt;0.001). The KMO measure for sampling adequacy was 0.826. So the sample was factorable.Exploratory factor analysis confirmed the one-factor structure that accounted for 56.49% variance withan eigenvalue of 2.825. A significant correlation was observed for WHO-5 with health expenditure andpostponement of check-up.Conclusion: The WHO-5 well-being index showed acceptable internal validity and construct validity witha one-dimensional structure.

Double burden of malnutrition among adolescents in rural West Bengal, India.

The aims of this study were to investigate the prevalence of underweight, stunting, and overweight among adolescents in rural West Bengal, India, and identify factors contributing to these forms of malnutrition. This was a cross-sectional study conducted within the Birbhum Health and Demographic Surveillance System in West Bengal, India. Participants were male and female adolescents 10 to 19 y of age (N = 5521). Body mass index (BMI) was calculated using measured heights and weights and z-scores based on the 2007 World Health Organization growth standards. Information on demographic characteristics, diet, and health behaviors was collected through face-to-face interviews using a standardized questionnaire. Modified Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between each risk factor and outcome. The proportion of underweight was 26.6% overall: 31.1% among boys, and 21.1% among girls. The proportion of stunting was 25% overall: 23.3% among boys and 26.9% among girls. Of the participants, 4.6% were overweight or obese: 4.1% boys and 5.2% girls. Compared with boys, girls had a reduced likelihood of being underweight (adjusted PR, 0.67; 95% CI, 0.59-0.75). Multivariate models also showed that socioeconomic status was strongly associated with all nutritional outcomes. Not having a toilet facility in one's household and poor hand hygiene were also associated with a greater likelihood of stunting. The present results suggested that adolescents in Birbhum, India are substantially affected by the double burden of malnutrition. Nutritional interventions should incorporate efforts to reduce socioeconomic inequality.