Urban Slum Community Research Articles

Contraceptive behaviors and awareness in an urban slum community of south India

Objective: To assess the factors associated with knowledge, attitude and behavior of contraception use among urban slum population in Chennai. Methods: A cross-sectional study was conducted in the urban slum of Anakaputhur, Chennai. Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling. Pregnant women, postnatal and postmenopausal women were excluded from the study. Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge, attitude, and practices. Data analysis was done using IBM SPSS version 22. Analytical test like Chi square and odds ratio (OR) were used to identify association between knowledge, attitude, and behavior of contraception with the associated variables and enter method of logistic regression analysis was done. Results: Out of the 360 respondents, 228 were females, with a mean age of (34±5) years. Approximately 43% demonstrated adequate knowledge of contraception use, and 91% were aware of at least one contraceptive method. Notably, 72% exhibited a positive attitude towards contraceptive use. Nevertheless, 43% (155 individuals) did not utilize any contraceptive method. Among contraceptive users, intrauterine devices were the most commonly adopted, followed by barrier methods and female sterilization. There was significant association between knowledge of contraception and education (aOR 7.29, 95% CI 2.93-18.10, P<0.05), age (aOR 2.04, 95% CI 1.193.50, P<0.05) and socioeconomic class (aOR 3.66, 95% CI 1.71-7.85, P<0.05; aOR 3.97, 95% CI 2.12-7.49, P<0.05). Regarding attitude towards contraception use, education (aOR 8.54, 95% CI 2.35-31.03, P<0.05), sex (aOR 0.15, 95% CI 0.06-0.37, P<0.05), age (aOR 0.53, 95% CI 0.28-0.99, P<0.05), socio-economic class (aOR 4.42, 95% CI 1.97-9.92, P<0.05; aOR 9.83, 95% CI 3.63-26.58, P<0.05) and number of children (aOR 10.04, 95% CI 4.26-23.66, P<0.05) were the variables that had a significant association. Conclusions: These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population. The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.

Analysis of Individual Aspects in Riverbank Slums on Sustainable Sanitation Development, Case Study: Bima City, NTB, Indonesia

Currently, 24.5% of the population of Bima City lack access to sanitation. The issue is predominantly concentrated in densely populated urban slums along the riverbanks, influenced by the cultural and societal context of Indonesian society. From 2021 to 2022, a comprehensive mixed-method study was conducted in three urban slums, applying the Integrated Framework for Sanitation Services (IFSS) to explore individual aspects within a socio-cultural context. Combining quantitative and qualitative methods, the research involved a household questionnaire survey and in-depth interviews (IDI). The study revealed that individual aspects are shaped by perceptions of the convenience of open defecation and latrine use as well as experiences with shared latrines, driving the adoption of private latrines. Challenges such as financial constraints and limited construction capabilities in urban slum communities often hinder latrine construction, though cultural and traditional values (adat) in the Bima community in urban slums help to alleviate these obstacles. A recommendation is made to enhance the monitoring of sanitation adoption progress, focusing on the sanitation system’s functioning and adherence to the sanitation hierarchy. Despite awareness of the importance of safe disposal, its impact on sanitation behavior in Bima City’s urban slums has been constrained, underscoring the imperative for effective behavior change communication strategies.

Water Supply Systems in Urban Slum Communities in Lagos, Nigeria: Between Self-supply and Co-production

By investigating the contribution of the ‘informal sector’, this article explores the resourcefulness of place-based practices and how they shape the urban water provision in Lagos. It also provides a detailed and critical view of the enormous efforts of inhabitants in urban slums in the daily water provision. Analysing the qualitative field data collected from observations, 89 semi-structured interviews (field notes), 6 focus group discussions and 12 expert interviews, water supply systems, the utilisation in slum communities and power and politics around it are exposed. Even if people can afford to pay the bills, the provision of urban services by state actors (or commissioned firms) is erratic and often not available. The daily infrastructure provision remains the responsibility of individuals and groups, mostly organised in complex yet fragile and changing networks. Drawing from the research on the existing, largely informal water supply in slum communities, this article argues for the recognition and pro-active implementation of hybrid approaches in the planning, implementation and administration of urban infrastructure. It calls for co-production and ‘hybrid water governance’.

A community health worker-led program to improve access to gestational diabetes screening in urban slums of Pune, India: Results from a mixed methods study.

The World Health Organization recommends all pregnant women receive screening for gestational diabetes (GDM) with a fasting oral glucose tolerance test (OGTT). However, very few women receive recommended screening in resource-limited countries like India. We implemented a community health worker (CHW)-delivered program to evaluate if home-based, CHW-delivered OGTT would increase GDM screening in a low-resource setting. We conducted a mixed methods study in two urban slum communities in Pune, India. CHWs were trained to deliver home-based, point-of-care fasting OGTT to women in their third trimester of pregnancy. The primary outcome was uptake of CHW-delivered OGTT. Secondary outcomes included GDM prevalence and linkage to GDM care. Individual interviews were conducted with purposively sampled pregnant women, CHWs, and local clinicians to assess barriers and facilitators of this approach. From October 2021-June 2022, 248 eligible pregnant women were identified. Of these, 223 (90%) accepted CHW-delivered OGTT and 31 (14%) were diagnosed with GDM. Thirty (97%) women diagnosed with GDM subsequently sought GDM care; only 10 (33%) received lifestyle counseling or pharmacologic therapy. Qualitative interviews indicated that CHW-delivered testing was considered highly acceptable as home-based testing saved time and was more convenient than clinic-based testing. Inconsistent clinical management of GDM was attributed to providers' lack of time to deliver counseling, and perceptions that low-income populations are not at risk for GDM. Convenience and trust in a CHW-delivered GDM screening program resulted in high access to gold-standard OGTT screening and identification of a high GDM prevalence among pregnant women in two urban slum communities. Appropriate linkage to care was limited by clinician time constraints and misperceptions of GDM risk. CHW-delivered GDM screening and counseling may improve health education and access to preventive healthcare, offloading busy public clinics in high-need, low-resource settings.

Prevalence of adolescent-reported food insecurity and the determinants including coping strategies living in urban slum communities of Bangladesh during the era of COVID-19: a cross-sectional study

BackgroundAs food insecurity (FI) continues to rise worldwide especially in developing countries like Bangladesh, adolescent experience of FI have received minimal attention globally. This study aimed to identify the prevalence of adolescent-reported FI and its association with individual and socio-environmental factors as well as coping strategies amongst a sample of adolescents living in urban slum areas of Bangladesh in the times of the Coronavirus 19 (COVID-19) pandemic.MethodsA descriptive cross sectional study was conducted amongst 326 adolescents (12–18 years) living in the urban slums of Narayanganj, Dhaka from April to May, 2022. Adolescent-reported FI was assessed using a structured questionnaire adopted from Household Food Insecurity Access Scale (HFIAS). Descriptive statistics, Chi-square tests and ordinal logistic regression were used to draw inference.ResultsPrevalence of adolescent-reported FI was high (46.6% moderate and 29.8% severe). The likelihood of experiencing moderate or severe FI versus no/mild FI were 1.7 times (95% Confidence Interval (CI) [1.1, 2.5]) higher in younger adolescents and 5 times (95% CI [2.3, 12.7]) higher in unemployed youth. Socio-environmental factors determining the economic status of a household such as higher number of family members, only one earning family member, unemployed father, no household assets, food aid received by the family during pandemic and positive COVID-19 infection in family were associated with moderate and severe FI. Coping strategies such as a higher number of food seeking strategies (Adjusted Odds Ratio (AOR) 3.4, 95% CI [1.9, 5.9]), substance use (AOR 6.2, 95% CI [1.2, 31.7]) and stopping school (AOR 3.3, 95% CI [1.9, 5.7]) increased odds for moderate and severe FI. Stratified by drop-out of school status, an association between food seeking strategies and FI remained significant among those school-going, while there was no association among those dropping out of school.ConclusionThis study showed that adolescents living in urban slum communities in Bangladesh are at very high risk of FI and resort to harmful coping strategies. Our study highlights the importance of further research in adolescent reported FI and coping strategies in low to middle income countries (LMICs) and create appropriate interventions to lower FI among this group and improve their state of health and wellbeing.

Nutritional Information and Food Consumption Pattern of Adolescents’ Secondary School Students in the Urban-Slum Communities of Ibadan, Oyo State, Nigeria

Nutritional status is influenced by the food consumed, health status, sanitary environment and accessibility to nutritional information. This study explored nutritional information and food consumption pattern of adolescents’ secondary school in urban slums, using students in public secondary schools in Ibadan North Local Government Area (IBNLGA), Oyo State, Nigeria. A descriptive study was conducted using a three stage random sampling technique to select 467 respondents. Data were collected using a semi-structured interviewer-administered questionnaire, anthropometric measurements, observational checklist, and Hellen Keller International food frequency questionnaire. Data were analyzed using descriptive statistics, Chi-square and logistic regression statistics. Results revealed among others that respondents’ favourite foods were cassava-based, and sources of nutrition information included teachers (41.8%), parents (33.8%), television (22.1%), radio (16.7%) and siblings (1.3%). The study concluded that many respondents were underweight partly due to poor food consumption pattern as a result of inadequate access to nutritional information. This study recommended more intensive approach to address health and nutrition issues by providing adequate nutritional information in this age group.

Community centred co-design methodology for designing and implementing socio-behavioural interventions to counter COVID-19 related misinformation among marginalized population living in the squatter settlements of Karachi, Pakistan: a methodology paper

BackgroundMisinformation regarding COVID-19 pandemic and vaccination is damaging COVID-19 vaccine trust and acceptance in Low- and Middle-Income Countries (LMIC). Identification of misinformation and designing locally acceptable solutions are needed to improve COVID-19 vaccine acceptance. This study aimed to utilize community-led co-design methodology to evaluate misinformation regarding COVID-19 and develop contextual interventions to address misinformation in a marginalized peri urban slum communities of Landhi town Karachi, Pakistan.MethodsThis study was conducted between January and December 2021, in marginalized peri-urban slum dwellers of Muslimabad Colony, Landhi Town Karachi, Pakistan. We used a community-centred co-design methodology embedded within mixed study design to identify misinformation, co-design, test and implement locally acceptable solutions. The co-design methodology involved five stages of the design thinking model: (1) Empathize, (2) Define, (3) Ideate, (4) Prototype, and (5) Test. The project involved active engagement and participation of wide range of stakeholders and community beneficiaries (end users) including local EPI vaccinators, informal healthcare workers, religious leaders (male and female), schoolteachers (male and female), local government representatives, community leaders, housewives, youth, and general population. To develop a trusting relationship, and understand local culture, values, practices, and traditions, we allowed one month of observation period (observe, engage, watch, and listen) in the beginning, followed by door-to-door survey along with focus group discussions (FGD) and in-depth interviews (IDI) at baseline. Co-design workshops (separate for male and female) were conducted at each stage of co-design methodology to design and test locally acceptable solutions.ConclusionCommunity-centred co-design methodology was not only successful in designing, testing, and evaluating locally acceptable solutions but it also actively engaged and empowered the marginalized population living in peri urban slum communities of Karachi, Pakistan.

Health-Seeking Behavior Regarding Coughs in Urban Slums in Lagos, Nigeria.

TB is a major cause of morbidity and mortality, with slum residents being disproportionately affected. This study aimed to assess health-seeking behavior among adult residents of slum communities presenting with coughs in Lagos, Nigeria. A community-based, cross-sectional study was conducted across six urban slums in Nigeria as part of community outreaches to mark World TB Day. A structured, pretested questionnaire was used to capture relevant sociodemographic details and questions regarding symptoms of coughs and related symptoms as well as care-seeking behavior. Data were explored, analyzed, and presented using descriptive statistics. A total of 632 respondents participated in this study. The majority were 25-34 years old (24.7%), male (65.8%), Christian (55.7%), married (73.7%), with secondary education (37.8%), with 3-4 persons per household (41%) and with 1-2 persons per room (44.5%). In total, 26.6% had had a cough for two weeks or more and were considered as presumptive TB patients. Overall, 37.2% of respondents with a cough visited patent proprietary medicine vendors (PPMVs) as the first port of call. Good health-seeking behavior was exhibited by only 36.2% of respondents. In total, 38.9% delayed seeking care from a health facility (government or private) more than one month after the onset of symptoms. None of the factors included in the multivariate analysis showed a significant association with good health-seeking behavior (i.e., visiting government or private hospitals/clinics). The poor health-seeking behavior, delay in seeking TB care and preference for PPMVs emphasizes the need for National tuberculosis programs (NTPs) to further engage these informal providers in TB prevention, diagnosis and treatment services in urban slum communities.

Trends of infant vaccination timeliness and completion in selected urban slum communities in Ibadan, Southwestern Nigeria: A four-year review.

Suboptimal infant vaccination is common in Nigeria and multiple interventions have been deployed to address the situation. Child health indicators are reported to be worse in urban slums compared with other urban areas, but urban data are usually not disaggregated to show these disparities. Examining the timeliness and completion of infant vaccination in urban slums is important to determine the effectiveness of existing interventions in improving infant vaccination among this vulnerable population. This study explored the trends of infant vaccination in selected urban slum communities in Ibadan, Southwest Nigeria between November 2014 and October 2018. This was a cross sectional study where infant vaccination data were extracted from the immunization clinic records of six primary health care centers that were providing infant vaccination services for seven urban slum communities. Data was analyzed using descriptive statistics and Chi square test at α = 05. A total of 5,934 infants vaccination records were reviewed, 2,895 (48.8%) were for female infants and 3,002(50.6%) were from Muslim families. Overall, only 0.6% infants had both timely and complete vaccination during the four years under study. The highest number of infants with timely and complete vaccination were seen in 2015(12.2%) and least in 2018(2.9%). Regarding timeliness of the vaccines, BCG, was the least timely among the vaccines given at birth and the pentavalent and oral polio vaccines' timeliness reduced as the age of the infants increased. Both yellow fever and measles vaccines were timelier than the pentavalent vaccines. Vaccines were most timely in 2016(31.3%) and least timely in 2018(12.1%). Those from Muslim families significantly had delayed and incomplete vaccinations compared with those from Chrisitan families (p = 0.026). Infant vaccinations were significantly delayed and incomplete in the study communities during the years reviewed. More focused interventions are required to ensure optimal vaccination of the infants.

Strengthening Kampala's Urban Referral System for Maternal and Newborn Care Through Establishment of an Emergency Call and Dispatch Center.

Most pregnant women living in urban slum communities in Uganda deliver at public health centers that are not equipped to provide emergency obstetric and newborn care. When obstetric emergencies occur, pregnant women are referred to a higher-level facility and are responsible for arranging and paying for their own transport. The Kampala Slum Maternal Newborn (MaNe) project developed and tested an emergency call and ambulance dispatch center and a mobile application to request, deploy, and track ambulances. We describe the development of these 2 interventions and findings on the feasibility, acceptability, and sustainability of the interventions. MaNe conducted a mixed-method feasibility study that included an assessment of the acceptability and demand of the interventions. In-depth interviews (N=26) were conducted with facility proprietors, health providers, ambulance drivers, Kampala Capital City Authority officers, and community members to understand the successes and challenges of establishing the call center and developing the mobile application. Thematic content analysis was done. Quantitative data from the call center dispatch logs were analyzed descriptively to complement the qualitative findings. Between April 2020 and June 2021, 10,183 calls were made to the emergency call and dispatch center. Of these, 25% were related to maternal and newborn health emergencies and 14% were COVID-19 related. An ambulance was dispatched to transfer or evacuate a patient in 35% of the calls. Participants acknowledged that the call center and mobile application allowed for efficient communication, coordination, and information flow between health facilities. Supportive district leadership facilitated the establishment of the call center and has taken over the operating costs of the center. The call center and referral application improved the coordination of drivers and ambulances and allowed facilities to prepare for and treat cases more efficiently.

PREVALENCE OF COMMON MENTAL DISORDERS AND ASSOCIATED COMORBID CONDITIONS IN AN URBAN SLUM OF INDORE, M.P – A CROSS-SECTIONAL STUDY

Introduction: Epidemiology plays an important role in providing interpretation of disease occurrence in populations, change of disease rate, and the associated factors related to occurrence. Physical health problems not only coexist with mental disorders such as depression, but can also predict the onset and persistence of depression. A study of a nationally representative sample of the United States showed 79% of all ill people were comorbid. Aims and Objectives: The aims of this study were to study the comorbid condition in subjects with common mental disorders (CMD). Methods: It was a community-based and cross-sectional study carried out in an urban Slum. Slum was divided into four quadrants and 10% of the population was taken. A total of 150 houses were visited by random sampling and the sample size was calculated to be 294. The study was recorded in a pilot tested pre-designed validated semi-structured questionnaire. Four hundred and twenty-three out of 467 people were included in the study which was conducted in two phases. First phase was the screening phase which included history, general examination, and demographic profile along with self-reporting questionnaire (SRQ-20) to measure the presence of mental illness. Socioeconomic status of family and quality of life was evaluated using Kuppuswami socioeconomic status scale. Subjects scored 7 and above selected for the study and further evaluated using mini international neuropsychiatric interview plus in the second phase. Results: In the present study, highest percentage of CMD was 26.47%, belonging to 16–25 age group and distress was found in 16.07% and severe distress in 7.80% with SRQ-20 scoring between 7 and 13 and >14, respectively, with higher proportion of females. The prevalence of CMD was 238.77/1000 and 11.88% and 8.91% subjects were found hypertensive and diabetic respectively. Conclusion: There is need to consider the impact of common psychological health problems that urban slum communities are facing today and CMD can be a major contributor to slum’s overall burden of functional impairment.

Improving timeliness and completion of infant vaccination among infants in Nigerian urban slums through older women's participation.

Nigerian urban slums have a high population of infants with suboptimal vaccination despite previous interventions. Older women traditionally play supervisory roles in infant care in Nigeria but their influence is untapped in infant vaccination. This study sought to determine if training of older women (≥35 years) in urban slum communities in Ibadan, South west Nigeria, and involving them in infant vaccination will improve infant vaccination timeliness and completion. This was a randomized experimental community study and pregnant women in their third trimester, residing in seven urban slum communities were randomized using their antenatal clinics (ANCs) into intervention (six ANCs) and control groups (six ANCs). The older women who will supervise the care of the infants of pregnant women in the intervention group had seven sessions of training on the importance of infant vaccination timeliness and completion. The vaccinations of the infants from both groups were compared from birth till 9 months. Data were analyzed using descriptive statistics and Chi square test at α = 0.05. There were 96 older women, 198 pregnant women (105 in intervention group and 93 controls) and 202 infants (109 in intervention group and 93 controls). Infants in the intervention group (67.9%) significantly had both timely and complete vaccinations compared with those in the control group (36.6%). Vaccines given at birth were the least timely in both groups. More infants whose older women caregiver were married had timely and complete vaccinations. Also, a higher proportion of male infants, low birth weight babies and infants with older women caregiver with at most two children had timely and completed vaccinations but these were not statistically significant. Training of older women caregivers improved infant vaccination timeliness and completion in these urban slum communities. This model may improve infant vaccination in other similar urban slum settings.

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.

Are better existing WASH practices in urban slums associated with a lower long-term risk of severe cholera? A prospective cohort study with 4 years of follow-up in Mirpur, Bangladesh

ObjectiveTo investigate the association between existing household water quality, sanitation and hygiene (WASH) practices and severe cholera risk in a dense urban slum where cholera is highly endemic.Design, setting and...

An update of intestinal helminth infections among urban slum communities in Bangladesh

To assess the prevalence of intestinal helminth infections and associated risk factors among people living in urban slums in Bangladesh. A cross-sectional study was conducted across three clusters: Dhaka, Sylhet and Chattogram. In total, 360 individuals divided into two groups (school-aged children and adults) provided stool samples and completed a semi-structured questionnaire. Parasitological assessment was performed using the formol-ether concentration technique. Overall, 31.7% (114/360) of participants had helminthiasis, with 13.3% (48/360) having mixed infections. Among the infected participants, school-aged children had a higher rate of infection (41.7%, 75/180) compared with adults (21.7%, 39/180). Ascaris lumbricoides was the predominant parasite, followed by hookworms, Trichuris trichiura, Hymenolepis nana, Enterobius vermicularis and Rhabditis sp. Parasitic infections were significantly associated with type of latrine used, direct exposure to soil, open defaecation, and presence of free-roaming animals. Despite continuous efforts to control helminthiasis, a substantial proportion of the study participants were infected with intestinal helminths. Ignorance of the roles of the environment and animals was influential, and had a negative impact on existing control interventions. An integrated public health and veterinary public health approach is required for sustainable control of intestinal helminthiasis.

Variability in the household use of cooking fuels: The importance of dishes cooked, non-cooking end uses, and seasonality in understanding fuel stacking in rural and urban slum communities in six north Indian states

Expanding the use of clean cooking fuels has been a priority for the Government of India in recent years to obtain potential public health and women’s empowerment benefits. Evidence to date suggests most recent clean fuel adopters continue to use polluting biomass for some household energy needs. However, the specific ways households use both polluting and clean fuels together, known as fuel stacking, is not fully understood.We use survey data from 2,765 households in rural communities and urban slums in six north Indian states to detail fuel stacking practices. Half of rural and one-third of urban slum households stacked a clean and polluting fuel together. We classify stackers into four groups based on their reported primary and secondary fuels (e.g., primary gas and secondary firewood). We observe significant variations in the intensity of secondary fuel use among households in the same stacking group. Across all stackers, about half use their secondary fuel daily, while about one-fifth use it less than once per week. Non-cooking energy needs, like space and water heating, motivates 40% of biomass users to use polluting fuels. Seasonality is another important consideration as 75% of fuel stackers reported switching their primary fuel across seasons of the year, with nearly 90% primarily using gas during the rainy season.Our results highlight considerable heterogeneity in fuel use behaviors among households in the same stacking category. We also underscore that cooking gas is popular and able to meet all cooking needs, but it is important to consider the use of biomass for non-cooking tasks to enable a complete transition to clean cooking fuels. These results signify the need for more nuanced fuel stacking information in policy design and program evaluation.

Socio demographic factors to assess leucorrhoea in married women of reproductive age group in an urban slum community

Background: Reproductive health is a critical part of general health and reproductive tract infections create a major health problem in developing nations. Leucorrhoea is a common but difficult condition to treat due to its uncertain aetiology. A variety of factors put women at risk of these infections and socio demographic factors play a substantial role. The purpose of the study was to find the prevalence of leucorrhoea and socio demographic risk factors associated with it.Methods: A community based cross-sectional study of 350 women aged between 18-49 years residing in an urban slum of Mumbai, having white discharge for more than 2 weeks. Systematic random sampling used. Statistical analysis of the significance of association of different socio demographic variables was done.Results: The prevalence of leucorrhoea was found to be 66.9%. It was found to be 48% in women aged 23-32 years with predominance amongst the Muslim population (i.e.,74%) and those belonging to Socio-economic class 2 had a higher proportion (i.e.,74.4%). Education had miser influence on leucorrhoea.Conclusions: Routine screening and periodic surveys to detect the pattern of discharge are needed to understand the common problem of leucorrhoea and help initiate appropriate medical treatment and personal hygiene.

A study on assessment of disability associated with common mental disorders in the slum population of Indore

Background: Changing life styles have increase chance of common mental disorders (CMD) which may lead to disability. Aims and Objectives: The aim of the study was (1) to assess CMD in urban slum community and (2) to gain attention of policy makers toward the mental health and its need of the community to address unmet care. Materials and Methods: A crosssectional study was conducted in which 423 people were screened with the help of a pretestedquestionnaire by Self Reporting Questionnaire (SRQ-20). All the subjects who scored 7 and more in SRQ-20 were further evaluated using Sheehan disability scale. Results: Out of 423 subject, 76.12% reported typical response within 7 in SRQ-20 scoring. Common mental disorder was found in 16.07% with SRQ-20 scoring between 7 and 13. Severe distress was found in 7.80% of the population with SRQ-20 score &gt;14. Among psychological distress group, females scored higher with 10.63%. In the severe distress group, again females scored higher with 4.96%, although this was not statistically significant. A total of 101 subjects were found to have CMD after screening the population and its prevalence come to 238.77 per thousand. Mild disability was found in 59.41% of the people with CMD and 34.65% moderate disability and 5.94% reported severely disability, which was not statistically significant. Conclusion: On the basis of our study findings, we conclude that their mental health requires attention, which is an essential part of an individual’s health. It is essential to design intervention that aim at allaying their distress which can improve their mental health, however, being of a descriptive nature and the study population coming from only one slum the above mentioned finding cannot be generalized.

Prevalence, Risk Factors, Awareness, and Control of Hypertension: A Cross-Sectional Study in an Urban Slum Area of Bangladesh

Background: Although hypertension was formerly thought to be a disease in affluent countries, recent data suggest that low- and middle-income countries account for three-quarters of the worldwide hypertension burden. Several studies have shown a high prevalence of HTN in Bangladesh, while data on urban slum areas are scarce. Objective: The purpose of this study was to assess the prevalence, risk factors, awareness, treatment, and control of hypertension in an urban slum area of Bangladesh. Methods: This cross-sectional study included 602 adults aged 18 years and above living in slum areas of Donia union at Kodomtali Thana, Dhaka, from September to October 2018 by simple random sampling. Multivariate logistic regression analysis was performed to predict the risk factors for hypertension. Results: A quarter of the urban slum dwellers were suffering from hypertension. Higher aged groups, 31 to 45 years [adjusted odds ratio (AOR): 2.56; 95% confidence interval (CI): 1.54-4.27] and 46 and above years [AOR: 5.13; 95% CI: 2.68-9.82], family history of hypertension [AOR: 1.93; 95% CI: 1.24-2.99], and obesity [AOR: 2.86; 95% CI: 1.34-6.12] were found to be the significant risk factors of hypertension. Middle socio-economic status [AOR: 0.56; 95% CI: 0.34-0.93] and underweight [AOR: 0.36; 95% CI: 0.15-0.83] showed negative association with hypertension. Among the hypertensive participants, 20.6% were aware of their hypertension, 16.8% were on antihypertensive treatment, and 7.7% had their blood pressure controlled. Conclusion: A high prevalence of hypertension associated with poor awareness and control in an urban slum community needs government initiatives for prevention.

Prevalence and Correlates of Vitamin A Insufficiency Among 12–18-Month-Old Children Living in Slums of Mumbai, India

ObjectivesWe aimed to determine the prevalence of baseline vitamin A insufficiency (VAI; serum retinol (SR) < 1.05μmol/L) and to identify potential correlates of SR and VAI in a population of 12–18-month-old children participating in a randomized controlled trial in urban slums in Mumbai, India. MethodsIn this cross-sectional analysis, we determined SR concentrations in archived serum samples (N = 118) that were collected from 12–18-month-old children in urban slum communities of Western Mumbai in March–October 2017. We adjusted SR measurements using the BRINDA adjustment method for C-reactive protein.1 Child, maternal and household characteristics were assessed as potential correlates. Linear [β(SE)] and binomial [RR (95% CI)] regressions were used to identify correlates of SR and VAI, respectively. Age and sex were retained in all models. ResultsThe children in this population had a median (IQR) age of 14.5 (12.4, 16.7) months, and 46.6% were girls. Almost a third (27.1%) were underweight (weight-for-age Z-score <-2) and 9.3% were wasted (weight-for-length Z-score <-2). One third (30.5%) were anemic (hemoglobin < 11g/dL) and 19.5% of children were zinc-deficient (Zn < 70μg/dL). Median (IQR) unadjusted SR was 1.1 (0.9, 1.4) μmol/L and VAI was present among 50 (42.4%) of the population. After adjusting for inflammation, SR was 1.2 (1.0, 1.5) μmol/L and VAI was present in 38 (32.2%) of children. In multivariate regressions, each nmol/L increase in vitamin D [25(OH)D] was associated with a 0.01 μmol/L increase in SR [β (SE) 0.01 (0.004), p = 0.004], and each additional child under 5 years living in the household was associated with lower SR [–0.13 (0.04), p = 0.003]. ConclusionsIn these 12–18-month-old children, VAI was prevalent in nearly two out of every five children. Funding SourcesDivision of Nutritional Sciences, Cornell University Harvest Plus.