Prevalence of Tobacco Use in Urban,Semi Urban and Rural Areas in and around Chennai City,India

Background

Tobacco use leads to many health complications and is a risk factor for the occurrence of cardio vascular diseases, lung and oral cancers, chronic bronchitis etc. Almost 6 million people die from tobacco-related causes every year. This study was conducted to measure the prevalence of tobacco use in three different areas around Chennai city, south India.

Methods

A survey of 7510 individuals aged > = 15 years was undertaken covering Chennai city (urban), Ambattur (semi-urban) and Sriperumbudur (rural) taluk. Details on tobacco use were collected using a questionnaire adapted from both Global Youth Tobacco Survey and Global Adults Tobacco Survey.

Results

The overall prevalence of tobacco use was significantly higher in the rural (23.7%) compared to semi-urban (20.9%) and urban (19.4%) areas (P value <0.001) Tobacco smoking prevalence was 14.3%, 13.9% and 12.4% in rural, semi-urban and urban areas respectively. The corresponding values for smokeless tobacco use were 9.5%, 7.0% and 7.0% respectively. Logistic regression analysis showed that the odds of using tobacco (with smoke or smokeless forms) was significantly higher among males, older individuals, alcoholics, in rural areas and slum localities. Behavioural pattern analysis of current tobacco users led to three groups (1) those who were not reached by family or friends to advice on harmful effects (2) those who were well aware of harmful effects of tobacco and even want to quit and (3) those are exposed to second hand/passive smoking at home and outside.

Conclusions

Tobacco use prevalence was significantly higher in rural areas, slum dwellers, males and older age groups in this region of south India. Women used mainly smokeless tobacco. Tobacco control programmes need to develop strategies to address the different subgroups among tobacco users. Public health facilities need to expand smoking cessation counseling services as well as provide pharmacotherapy where necessary.     

Synanthropic Mites of Kolkata, India: An Ecological Appraisal

Ecological observations were made on house dust mites of Kolkata as they form a major part of synanthropic mite community. Dust samples were collected with regard to the abundance of mite in relation to certain socio-ecological parameters like, habitat preference, location of house, construction pattern of house, types of mattresses used and the frequency of cleaning of mattresses. Among two different habitats examined, bed dust contained significantly higher mite population (p < 0.01) than the corresponding bedroom floor dust. The density of total mites and glycyphagids are significantly higher in rural houses in comparison to those of urban houses. In contrast, rural houses contained least number of pyroglyphids/g of dust. The density of total mites as well as pyroglyphid mites/g of dust are higher in mud house in comparison to concrete house. The density of total mites, pyroglyphids and glycyphagids are higher in cotton mattress in comparison to that of foam mattress. The frequency of cleaning has a significant effect on reducing mite densities i.e., the more the frequency of cleaning the lesser are the mite densities.     

Urban Areas and Isolated Remnants of Natural Habitats: An Action Proposal for Botanical Gardens

The International Union for Conservation of Nature and Natural Resources (IUCN) and the World Wide Fund for Nature (WWF) advocates an increase of the number of botanical gardens throughout the world as one of the measures that can help to preserve the world's biodiversity. To implement this strategy, the present work brings forward a suggestion particularly suited to tropical regions: establishing municipal botanical gardens. It refers to the experience of a newly opened municipal botanical garden in Brazil, comparing its attractive power on visitors to that of other botanical gardens included in the Brazilian network of Botanical Gardens. It also presents considerations on in situ conservation in small remnants and on the importance of urban reserves to preserve the regional biodiversity and spread the conservationist philosophy. The present proposal promotes the participation of local communities making the public opinion more aware and active, besides being able to counterbalance proposals that support protecting the world biodiversity through interventionist actions. It assumes that, through actions planned and coordinated by regional and national botanical garden networks, the measure proposed can mitigate the anthropic actions exerted on important natural reserves all over the world.     

Comparison of Characteristics between Patients with H7N9 Living in Rural and Urban Areas of Zhejiang Province,China: A Preliminary Report

A total of 134 cases of H7N9 influenza infection were identified in 12 provinces of China between March 25 and September 31, 2013. Of these, 46 cases occurred in Zhejiang Province. We carried out a preliminary comparison of characteristics between rural and urban H7N9 cases from Zhejiang Province, China. Field investigations were conducted for each confirmed H7N9 case. A standardized questionnaire was used to collect information about demographics, exposure history, clinical signs and symptoms, timelines of medical visits and care after onset of illness. Of the 46 H7N9 cases in Zhejiang Province identified between March 25 and September 31, 2013, there were 16 rural cases and 30 urban cases. Compared to urban cases, there was a higher proportion of females among the rural cases [11/16 (69%) vs. 6/30 (20%), P = 0.001]. Among the rural cases, 14/15 (93%) with available data had a history of recent poultry exposure, which was significantly higher than that among urban cases (64%, P = 0.038). More patients from the rural group had a history of breeding poultry compared with those from the urban group [38% (6/16) vs. 10% (3/30), respectively; P = 0.025]. Interestingly, the median number of medical visits of patients from rural areas was higher than that of patients from urban areas (P = 0.046). There was no difference between the two groups in terms of age distribution, fatality rate, incubation period, symptoms, and underlying medical conditions. In conclusion, compared to patients from urban areas, more patients from rural areas were female, had an exposure history, had a history of breeding poultry, and had a higher number of medical visits. These findings indicate that there are different exposure patterns between patients living in rural and urban areas and that more rural cases were infected through backyard poultry breeding.     

Low Birth Weight and Normal Birth Weight Newborns of Kolkata, India: Comparison of Some Maternal Risk Factors

This study compared several maternal risk factors of low birth weight (LBW) between 204 normal birth weight (NBW) and 133 LBW newborns from Kolkata, India. Based on their birth weight (BW), newborns were classified as LBW (BW < 2.5 kg) and NBW (BW ≥ 2.5 kg). Results revealed that means for maternal age (MA, p < 0.05), gestational age (GA, p < 0.01), hemoglobin (Hb) concentration (p < 0.05), and per capita daily income (PCDI, p < 0.05) were significantly higher among mothers of NBW. Correlation analyses revealed that MA (r = 0.119, p < 0.05), GA (r = 0.583, p < 0.01), PCDI (r = 0.118, p < 0.05), and Hb (r = 0.138, p < 0.05) were significantly positively correlated with BW; PCDI was also significantly positively correlated (r = 0.142, p < 0.01) with Hb. Stepwise regression analyses with BW as the dependent variable revealed that GA (t = 7.915, p < 0.001) and Hb (t = 2.057, p < 0.05) were the most important predictive variables. The effect of Hb, independent of GA, was statistically significant (change in F = 4.231, p < 0.05). Because GA is not modifiable in pregnant women, there is a need to increase Hb levels among pregnant mothers. Most importantly, appropriately targeted preventive strategies, including iron supplementation, need to be implemented for health promotion.     

A Multi-country Study of the Household Willingness-to-Pay for Dengue Vaccines: Household Surveys in Vietnam,Thailand, and Colombia

BackgroundThe rise in dengue fever cases and the absence of dengue vaccines will likely cause governments to consider various types of effective means for controlling the disease. Given strong public interests in potential dengue vaccines, it is essential to understand the private economic benefits of dengue vaccines for accelerated introduction of vaccines into the public sector program and private markets of high-risk countries.Conclusions/SignificanceKnowing that dengue vaccines are not yet available, our study provides critical information to both public and private sectors. The study results can be used to ensure broad coverage with an affordable price and incorporated into cost benefit analyses, which can inform prioritization of alternative health interventions at the national level.     

Body Mass Index and Chronic Energy Deficiency Among Urban Bengalee Male Slum Dwellers of Kolkata, India: Relationship with Family Income

A cross-sectional study of 191 adult (>18 years) Bengalee male slum dwellers of Kolkata, India, was undertaken to study the relationships of family income with body mass index (BMI) and chronic energy deficiency (CED). Results revealed that the mean height, weight, and BMI of the subjects were 162.2 cm, 54.0 kg, and 20.5 kg/m², respectively. The overall frequency of CED (BMI < 18.5 kg/m²) was 33.5%. Based on the World Health Organization classification, the prevalence of CED among this population was high (20–39%) and thus the situation is serious. Overall, monthly family income (MFI) was significantly positively correlated (r = 0.18, p < 0.05) with BMI. Linear regression analyses showed that MFI had significant impact (p < 0.05) on BMI. The percent variation in BMI explained by MFI was 2.6%. Subjects belonging to the lowest family income group (FIG) had the lowest mean BMI (19.5 kg/m²) and the highest rate of CED (46.6%) while those in the highest FIG had the largest mean BMI (21.4 kg/m²) and lowest rate of CED (23.1%). There was a significant FIG difference (F = 2.965, p < 0.05) in mean BMI. Moreover, there existed FIG differences (χ ² = 7.54, p < 0.06) in CED rates. In conclusion, this study provided strong evidence that FIG was significantly associated with BMI and the presence of CED. The rate of CED was high, indicating a serious situation. These findings may have severe public health implications. It is recommended that immediate nutritional intervention programs be initiated among this population along with serious efforts to increase their family income.     

3种城市生境间蚂蚁群落组成的比较研究——以四川省南充市城区为例

作为重要的人为影响因素,城市化改变了自然生境的景观结构,并影响到动物群落的组成。蚁科Formicidae动物种类繁多,且易于捕获,是研究城市中不同土地利用类型对动物群落影响的理想指示生物。2018年5月,在四川省南充市城区中选择"公园与绿地""旱地"和"乔木林地"3种土地利用类型作为不同的生境类型,并通过陷阱法对蚂蚁群落组成进行调查。共采集到1 847只个体;其中,津岛铺道蚁Tetramorium tsushimae在"公园与绿地"中的个体数占比最高(73.80%),并明显高于"旱地"群落中占比最高的中华小家蚁Monomorium chinense(25.48%)和"乔木林地"群落中占比最高的宽结大头蚁Pheidole nodus(28.79%)。3种生境间,群落的蚂蚁个体数和物种丰富度间差异无统计学意义,但"公园与绿地"的Simpson多样性指数和Pielou均匀度指数均显著低于"旱地"和"乔木林地"的;"公园与绿地"(q=0.444)和"旱地"(q=0.500)与"乔木林地"间的群落组成均存在中度不相似,而"公园与绿地"与"旱地"间为中度相似(q=0.647)。因此,不同的城市土地...     

Hypertension,a Neglected Disease in Rural and Urban Areas in Moramanga,Madagascar

Background

Hypertension is one of the main risk factors of cardiovascular diseases. In Madagascar, studies on hypertension in urban and rural communities are scarce.

Objectives

The aim of this study was to determine the prevalence of hypertension and identify associated risk factors in adults living in a health and demographic system in Moramanga, Madagascar.

Methods

The study included people aged 15 years old and above living in a health and demographic system in Moramanga. A household census was performed in 2012 to enumerate the population in 3 communities in Moramanga. In addition to the questionnaire used in the initial census, a standardized questionnaire and blood pressure were taken twice after 5 and 10 minutes of rest. In urban areas, heights and weights were also measured to calculate the body mass index.

Results

There were 3621 and 4010 participants respectively in rural and urban areas. Prevalence of hypertension in rural population was 27.0% (IC95% [25.6–28.5]) and 29.7% (IC95% [28.3–31.1]) in urban population. Among hypertensive subjects, 1.7% (17/979) and 5.3% (64/1191) were on antihypertensive treatment for at least 1 month before the survey in rural and urban population, respectively. In rural areas, increasing age (65 years and older vs 18–25 years OR = 11.81, IC95% [7.79–18.07]), giving more than 3 positive responses to the usual risks factors of hypertension (OR = 1.67, IC95% [1.14–2.42]) and singles in comparison with married people (OR = 1.61, IC95% [1.20–2.17]) were associated to hypertension in a logistic regression model. In urban areas, increasing age (65 years and older vs 18–25 years OR = 37.54, IC95% [24.81–57.92]), more than 3 positive responses to the usual risks of hypertension (OR = 3.47, IC95% [2.58–4.67]) and obesity (OR = 2.45, IC95% [1.56–3.87]) were found as risk factors.

Conclusion

Hypertension is highly prevalent in rural areas although it is significantly less treated. As a result, a major epidemic of cardiovascular diseases is at risk in Madagascar’s progressively aging society.     

A Survey of Dog Populations in Urban and Rural Areas of Yucatan,Mexico

ABSTRACT

A survey in a major Mexican city (Merida) and three rural communities was conducted to generate information regarding the size and structure of the owned-dog populations and people's opinions about the dogs and how they took care of them. Household characteristics and dog population size, health and reproductive issues were compared between the two kinds of communities: urban and rural. A telephone survey was conducted in Merida city whereas personal interviews were used in the rural communities. Local veterinarians were also interviewed to evaluate their influence on the dog populations in Merida city. The ratio of people to dogs was 3.4:1 in the city, and 1.7:1 to 4.6:1 in the different rural communities. In general it was more common to find a dog-owning household in the city of Merida (72.8%) than in the rural areas (63.6%, 65.5% and 71.1%), and in the city more households had adequate fences to restrain dogs. Larger families were more likely to own a dog than small families. Households of medium socio-economic status had a significantly higher probability of owning a dog than households of low or high socio-economic status. Of the dogs in the city, 90.1% were vaccinated against rabies compared with 62.3% of the dogs in the rural communities. Most animals were intact; the frequency of neutering/spaying was 3.1% in Merida and 1.8% in the rural communities. Few private veterinary practitioners were involved in the control of dog overpopulation. It is concluded that dogs are popular pets both in urban and rural Yucatan. People's opinions about dogs and the level of supervision varied with socio-economic status, and people in the city provided better food, shelter and preventive medicine. The veterinary practitioners did little to promote the control of dog breeding or to reduce the relinquishing of unwanted dogs in the city. Better client education and the promotion of sterilization of pets at low cost would improve the situation.     

The Hidden Burden of Dengue and Chikungunya in Chennai,India

Background

Dengue and chikungunya are rapidly expanding viruses transmitted by mosquitoes of the genus Aedes. Few epidemiological studies have examined the extent of transmission of these infections in South India despite an increase in the number of reported cases, and a high suitability for transmission.

Methods and findings

We conducted a household-based seroprevalence survey among 1010 individuals aged 5-40 years living in fifty randomly selected spatial locations in Chennai, Tamil Nadu. Participants were asked to provide a venous blood sample and to complete a brief questionnaire with basic demographic and daily activity information. Previous exposure to dengue and chikungunya was determined using IgG indirect ELISA (Panbio) and IgG ELISA (Novatec), respectively. We used this data to estimate key transmission parameters (force of infection and basic reproductive number) and to explore factors associated with seropositivity. While only 1% of participants reported history of dengue and 20% of chikungunya, we found that 93% (95%CI 89-95%) of participants were seropositive to dengue virus, and 44% (95%CI 37-50%) to chikungunya. Age-specific seroprevalence was consistent with long-tem, endemic circulation of dengue and suggestive of epidemic chikungunya transmission. Seropositivity to dengue and chikungunya were significantly correlated, even after adjusting for individual and household factors. We estimate that 23% of the susceptible population gets infected by dengue each year, corresponding to approximately 228,000 infections. This transmission intensity is significantly higher than that estimated in known hyperendemic settings in Southeast Asia and the Americas.

Conclusions

These results provide unprecedented insight into the very high transmission potential of dengue and chikungunya in Chennai and underscore the need for enhanced surveillance and control methods.     

Dengue Fever Occurrence and Vector Detection by Larval Survey, Ovitrap and MosquiTRAP: A Space-Time Clusters Analysis

The use of vector surveillance tools for preventing dengue disease requires fine assessment of risk, in order to improve vector control activities. Nevertheless, the thresholds between vector detection and dengue fever occurrence are currently not well established. In Belo Horizonte (Minas Gerais, Brazil), dengue has been endemic for several years. From January 2007 to June 2008, the dengue vector Aedes (Stegomyia) aegypti was monitored by ovitrap, the sticky-trap MosquiTRAP™ and larval surveys in an study area in Belo Horizonte. Using a space-time scan for clusters detection implemented in SaTScan software, the vector presence recorded by the different monitoring methods was evaluated. Clusters of vectors and dengue fever were detected. It was verified that ovitrap and MosquiTRAP vector detection methods predicted dengue occurrence better than larval survey, both spatially and temporally. MosquiTRAP and ovitrap presented similar results of space-time intersections to dengue fever clusters. Nevertheless ovitrap clusters presented longer duration periods than MosquiTRAP ones, less acuratelly signalizing the dengue risk areas, since the detection of vector clusters during most of the study period was not necessarily correlated to dengue fever occurrence. It was verified that ovitrap clusters occurred more than 200 days (values ranged from 97.0±35.35 to 283.0±168.4 days) before dengue fever clusters, whereas MosquiTRAP clusters preceded dengue fever clusters by approximately 80 days (values ranged from 65.5±58.7 to 94.0±14. 3 days), the former showing to be more temporally precise. Thus, in the present cluster analysis study MosquiTRAP presented superior results for signaling dengue transmission risks both geographically and temporally. Since early detection is crucial for planning and deploying effective preventions, MosquiTRAP showed to be a reliable tool and this method provides groundwork for the development of even more precise tools.     

Adiposity,central body fat distribution and blood pressure among young Bengalee adults of Kolkata,India: sexual dimorphism

A cross-sectional study of 174 men and 153 women of Bengalee ethnicity was undertaken to compare levels of adiposity, central body fat distribution and blood pressure. The mean age of both the sexes were similar (men = 20.1 years; women = 20.0 years). Significantly more women (n = 42, 27.5%) were overweight (body mass index, BMI > or = 25.0 kg/m2) as compared with men (19, 10.9%). Men were significantly taller and heavier. They also had significantly greater mean waist (WC) and mid upper arm (MUAC) circumferences compared with women. On the other hand, women had significantly (p < 0.001) greater mean BMI, biceps (BSF), triceps (TSF) and subscapular (SSF) skinfolds. The mean values of systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure were significantly greater among men. These significant differences existed even after controlling for BMI. Regression analyses revealed that sex had significant effect on all these variables even after controlling for BMI. Correlation studies showed that WC was found to be much more strongly correlated than BMI with SBP, DBP and MAP, in both sexes. However, when the effect of WC (along with BMI) was also controlled for, there was no significant sex difference in blood pressure.     

Dispersal of Adult Culex Mosquitoes in an Urban West Nile Virus Hotspot: A Mark-Capture Study Incorporating Stable Isotope Enrichment of Natural Larval Habitats

Dispersal is a critical life history behavior for mosquitoes and is important for the spread of mosquito-borne disease. We implemented the first stable isotope mark-capture study to measure mosquito dispersal, focusing on Culex pipiens in southwest suburban Chicago, Illinois, a hotspot of West Nile virus (WNV) transmission. We enriched nine catch basins in 2010 and 2011 with ¹⁵N-potassium nitrate and detected dispersal of enriched adult females emerging from these catch basins using CDC light and gravid traps to distances as far as 3 km. We detected 12 isotopically enriched pools of mosquitoes out of 2,442 tested during the two years and calculated a mean dispersal distance of 1.15 km and maximum flight range of 2.48 km. According to a logistic distribution function, 90% of the female Culex mosquitoes stayed within 3 km of their larval habitat, which corresponds with the distance-limited genetic variation of WNV observed in this study region. This study provides new insights on the dispersal of the most important vector of WNV in the eastern United States and demonstrates the utility of stable isotope enrichment for studying the biology of mosquitoes in other disease systems.     

Case-Control Study on the Role of Enterotoxigenic Bacteroides fragilis as a Cause of Diarrhea among Children in Kolkata,India

A total of 874 fecal specimens (446 diarrheal cases and 428 controls) from diarrheal children admitted in the Infectious Diseases Hospital, Kolkata and age and sex matched asymptomatic subjects from an urban community were assessed for the prevalence of enterotoxigenic Bacteroides fragilis (ETBF). Isolates of B. fragilis were tested for the presence of enterotoxin gene (bft) by PCR. The detection rate of ETBF was 7.2% (63 of 874 specimens) that prevailed equally in diarrheal cases and controls (7.2% each; 32 of 446 cases and 31 of 428 controls). Male children up to one year age group was significantly (p<0.05) associated with ETBF infection as compared to children > 2 years of age in cases and controls. In 25 ETBF isolates, the bft gene was genotyped using PCR-RFLP and only two alleles were identified with prevalence rate of 40% and 60% for bft-1 and bft-3, respectively. All the ETBF isolates were susceptible for chloramphenicol and imipenem but resistant to clindamycin (48%), moxifloxacin (44%) and metronidazole (32%). Resistance of ETBF to moxifloxacin (44%) and metronidazole is an emerging trend. Pulsed-field gel electrophoresis (PFGE) revealed that majority of the ETBF isolates are genetically diverse. In the dendrogram analysis, two clusters were identified, one with ETBF resistant to 5–8 antimicrobials and the other cluster with metronidazole and moxifloxacin susceptible isolates from diarrheal cases. To our knowledge, this is the first detailed report on ETBF from India indicating its clinical importance and molecular characteristics.