Determinants of nutritional status of pre-school children in India

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.     

Trends in consanguinity in South India

This study uses data from the 1992-93 National Family Health Survey to assess trends in consanguinity in the South Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. In Kerala, the frequency of consanguineous marriages is very low and one type of preferred marriage of the Dravidian marriage system uncle niece marriage--is conspicuously absent. In the other states of South India, consanguinity and the coefficient of inbreeding are high. While no change in consanguinity is observed during the past three to four decades in Karnataka, a definite decline is observed in Andhra Pradesh and Tamil Nadu. Due to recent changes in the demographic and social situation in these states, this decline in consanguinity is likely to continue.     

Age at return marriage and timing of first birth in India's Uttar Pradesh and Kerala states.

The study investigates the relationship between age at marriage and the length of first birth interval in two states of India: Uttar Pradesh and Kerala. Life tables of first-birth intervals and median first-birth intervals are computed for several subgroups of the study population. Multivariate hazards modelling technique is used to study the net effect of age at marriage, controlling for a multiple of socioeconomic factors. The result shows that the average first-birth interval varies by age at marriage and is much longer in Uttar Pradesh than in Kerala.     

Age at return marriage and timing of first birth in India's Uttar Pradesh and Kerala states

Abstract

The study investigates the relationship between age at marriage and the length of first birth interval in two states of India: Uttar Pradesh and Kerala. Life tables of first‐birth intervals and median first‐birth intervals are computed for several subgroups of the study population. Multivariate hazards modelling technique is used to study the net effect of age at marriage, controlling for a multiple of socioeconomic factors. The result shows that the average first‐birth interval varies by age at marriage and is much longer in Uttar Pradesh than in Kerala.     

Nonmetric cranial variation and biological distances between samples of six nontribal populations of India

Sixty-nine nonmetrical morphological variants of the cranium have been studied in six samples of non-tribal, state populations in India, and their incidence reported. Using C.A.B. Smith’s angular transformation of frequencies, the multivariate Thetasquare distances and their respective standard deviations have been presented. On the basis of nonmetrical cranial variation, it is clear that the samples from Uttar Pradesh, Andhra Pradesh and Bihar are closer to each other but distant from Madhya Pradesh, Karnataka and Maharashtra. On the other hand, Karnataka and Maharashtra samples are quite close to each other and both, in turn, are comparatively closer to Madhya Pradesh than to Uttar Pradesh, Andhra Pradesh and Bihar. Madhya Pradesh sample emerges as the most divergent group among the six population samples studied. This, in general, is in conformity with the picture that emerges from various analysis of morphometric and other biological data on various populations of India.     

Neonatal mortality in the empowered action group states of India: trends and determinants

In India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh, referred to as the Empowered Action Group (EAG) states, lag behind in the demographic transition and have the highest infant mortality rates in the country. Neonatal mortality constitutes about 60% of the total infant mortality in India and is highest in the EAG states. This study assesses the levels and trends in neonatal mortality in the EAG states and examines the impact of bio-demographic compared with health care determinants on neonatal mortality. Data from India's Sample Registration System (SRS) and National Family and Health Survey (NFHS-2, 1998-99) are used. Cox proportional hazard models are applied to estimate adjusted neonatal mortality rates by health care, bio-demographic and socioeconomic determinants. Variations in neonatal mortality by these determinants suggest that universal coverage of all pregnant women with full antenatal care, providing assistance at delivery and postnatal care including emergency care are critical inputs for achieving a reduction in neonatal mortality. Health interventions are also required that focus on curtailing the high risk of neonatal deaths arising from the mothers' younger age at childbirth, low birth weight of children and higher order births with short birth intervals.     

Correlates of female sterilization regret in the southern states of India

This study analyses factors associated with the incidence of sterilization regret in the four south Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. Using data from the National Family Health Surveys, in all four states the incidence of regret was found to be less than 10% and the factors significantly associated with it were child loss experience and quality of services. Hence, there is a need to improve the quality of services, both in terms of counselling and service provision, and women need to be counselled about the permanent nature of sterilization in order to avoid future regret.     

Presence of Wolbachia endosymbionts in microfilariae of Wuchereria bancrofti (Spirurida: Onchocercidae) from different geographical regions in India

In view of the recent discovery of rickettsial endosymbionts, Wolbachia in lymphatic filarial parasites, Wuchereria bancrofti and Brugia malayi and subsequently of their vital role in the survival and development of the latter, antibiotics such as tetracycline are being suggested for the treatment of lymphatic filariasis, by way of eliminating the endosymbiont. But, it is essential to assess their presence in parasites from areas endemic for lymphatic filariasis before such a new control tool is employed. In the present communication, we report the detection of Wolbachia endosymbionts in microfilariae of W. bancrofti parasites collected from geographically distant locations of India, such as Pondicherry (Union Territory), Calicut (Kerala), Jagadalpur (Madhya Pradesh), Thirukoilur (TamilNadu), Chinnanergunam (TamilNadu), Rajahmundry (Andhra Pradesh), and Varanasi (Uttar Pradesh), using Wolbachia specific 16S rDNA polymerase chain reaction.     

Socioeconomic and demographic diversity in the health status of elderly people in a transitional society, Kerala, India

Kerala State in India is the most advanced in terms of demographic and epidemiological transition and has the highest proportion of elderly population. The study examines the socio-demographic correlates of health status of elderly persons in Kerala in terms of three components: perceived health status, physical mobility and morbidity level. Overall health status was measured by combining the above three components of health status. Data from the 60th National Sample Survey Organization (NSSO) on Condition and Health Care of the Aged in Kerala in 2004 was used for the study. Significant socio-demographic differentials in health status were noted. While women report less morbidity, perceived well-being and physical mobility was better for men. This anomaly can be explained by variations in the components of socio-demographic factors. The findings call for urgent health care strategies for elderly persons in different socio-demographic groups in transitional Indian states like Kerala.     

PGM1 subtype polymorphism in 14 endogamous Dravidian-speaking populations of South India

Red cell hemolysates from 1,004 persons belonging to 14 population groups drawn from four South Indian states, Andhra Pradesh, Tamil Nadu, Karnataka, and Kerala, were tested for PGM1 subtypes. The groups are characterized by a high frequency of phenotype 1+1+ (range 36.98-71.64%) and the allele 1+ (range 60-79%). The groups exhibit marked heterogeneity for PGM1 locus. The results show a clear demarcation between tribes and Brahmin groups.     

Analysis of molecular genetic diversity in a representative collection of foxtail millet [Setaria italica (L.) P. Beauv.] from different agro-ecological regions of India

Foxtail millet [Setaria italica (L.) P. Beauv.], an important crop of East Asia is known for its drought tolerance and was once an indispensible crop of vast rainfed areas in semi-arid regions in India. In India it is cultivated in Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu, Rajasthan, Madhya Pradesh, Uttar Pradesh and north eastern states. The grain finds use in several local recipes such as roti (bread), jaula, singal, sirol. Foxtail millet grain contains 12.3 % protein, 4.7 % fat, 60.6 % carbohydrates, and 3.2 % ash. The present study was conducted to analyse the genetic diversity among foxtail accessions from different states of India and a few exotic accessions using RAPD and ISSR techniques and identify diverse accessions for use in variety improvement programmes. A set of 125 foxtail millet accessions selected from 11 different agro-ecological regions of India were analyzed using random amplified polymorphic DNA (RAPD) and inter simple sequence repeat (ISSR) marker techniques. A total of 146 (115 RAPD and 31 ISSR) scoreable markers were generated with 16 RAPD and four ISSR primers. The dendrogram generated using Nei’s genetic distances and principal component analyses revealed presence of two clusters and two subclusters in group I. The accessions from Andhra Pradesh, Karnataka, Maharashtra and Uttarakhand were more diverse since they were distributed in both the clusters. There was no clear geographical differentiation observable. The bootstrap support for the major groups identified was strong (above 80 %) indicating good statistical support. The average value of Nei and Li’s genetic distance was lowest (0.081) for accessions from West Bengal while the collections from Karnataka showed highest dissimilarity (average genetic distance = 0.239). The average genetic distance for all 125 accessions together was 0.177 indicating presence of only moderate genetic diversity in the collections. The analysis of molecular variance indicated that only 2.76 % variation was explained by variations among the groups and 11.55 % among populations within groups. However the percentage of variation observed within populations was high (85.68). The value of Fst was observed to be very low (0.028) indicating low differentiation of the accessions analysed. The population genetic analysis carried out indicates that highest number of alleles per locus (1.745 ± 0.438) was observed for Andhra Pradesh with 35 accessions. When four eco-geographic regions were considered, the southern region comprising AP, Karnataka and TN showed the highest number of alleles per locus (1.787 ± 0.411). The value of Gst was lowest for south (0.123) and highest for central west (0.455). This indicated that all the landraces from south share common alleles. The gene flow between the accessions from different regions was also observed to be high with the highest migration (3.557) recorded for south.     

Non-metric variation of the skull in samples of four Indian populations

Four skeletal samples from the states of Uttar Pradesh, Bihar, and Andhra Pradesh in India are compared using cranial non-metric traits. The skeletal “epigenetic” distances correspond with the geographic pattern of separation, also demonstrating variable correspondence with known genetic relationships of the living populations.     

HIV prevention in high-risk women in South Africa: condom use and the need for change

Introduction

Young women are at disproportionate risk of HIV infection in South Africa. Understanding risk behaviors and factors associated with ability to negotiate safe sex and condom use is likely to be key in curbing the spread of HIV. Traditionally prevention efforts have focused on creating behavioral changes by increasing knowledge about HIV/AIDS.

Methods

This was a cross-sectional analysis from a prospective observational cohort study of 245 women at a high-risk of HIV infection in KwaZulu-Natal, South Africa.

Results

Participants demonstrated a high level of HIV/AIDS knowledge. Overall, 60.3% of participants reported condom use. Reported condom use at last sexual encounter varied slightly by partner type (57.0% with steady versus 64.4% with casual partners), and self-perceived ability to choose to use a condom was significantly lower with steady partners compared to casual partners (p<0.01). In multivariate analysis, women who had high school education were more likely to use condoms at their last sex encounter compared to those with only primary school education (RR of 1.36 (95% Confidence Interval (CI) 1.06–1.75) and 1.46 (95% CI 1.13–1.88) for grades 8–10 and 11–12, respectively). Those who used condoms as a contraceptive method were twice as likely to use condoms compared to women who did not report using them as a contraceptive method. Greater perceived ability to choose to use condoms was associated with higher self-reported condom use at last encounter, irrespective of partner type (RR = 2.65 (95% CI 2.15–32.5).

Discussion

Self-perceived ability to use condoms, level of formal education and condom use as a contraceptive were all significantly associated with self-reported condom use at last sexual encounter. These findings suggest that that gender inequality and access to formal education, as opposed to lack of HIV/AIDS knowledge, prevent safer sexual practices in South Africa.     

Brachystelma annamacharyae sp. nov. (Apocynaceae) from the Seshachalam hills of Andhra Pradesh (India)

Brachystelma annamacharyae K. Prasad, Prasanna, Meve, Sankara Rao & T. Thulasaiah, a new species from the Sanipaya beat in the Seshachalam hills in Andhra Pradesh (India) is described and illustrated. The new species shares the long filiform pedicels, reflexed corolla lobes and an exposed corona with its most closely allied species, B. swarupa from Kerala and B. ciliatum from Karnataka and Andhra Pradesh, but differs from these by generally dwarfed and completely glabrous vegetative parts and uniflowered inflorescences, therby resembling certain South African species of the genus.     

Prevention of Parent to Child Transmission (PPTCT) Program Data in India: An Emerging Data Set for Appraising the HIV Epidemic

Background

Evidence based resource allocation and decentralized planning of an effective HIV/AIDS response requires reliable information on levels and trends of HIV at national and sub-national geographic levels. HIV sentinel surveillance data from antenatal clinics (HSS-ANC) has been an important data source to assess the HIV/AIDS epidemic in India, but has a number of limitations. We assess the value of Prevention of Parent to Child Transmission (PPTCT) programme data to appraise the HIV epidemic in India.

Methods/Findings

HIV data from PPTCT sites were compared to HSS-ANC and general population level surveys at various geographic levels in the states of Karnataka, Maharashtra and Andhra Pradesh. Chi-square tests were used to ascertain statistical significance. PPTCT HIV prevalence was significantly lower than HSS-ANC HIV prevalence (0.92% vs. 1.22% in Andhra Pradesh, 0.65% vs. 0.89% in Karnataka, 0.52% vs. 0.60% in Maharashtra, p<0.001 for all three states). In all three states, HIV prevalence from PPTCT centres that were part of the sentinel surveillance was comparable to HSS-ANC prevalence but significantly higher than PPTCT centres that were not part of the sentinel surveillance. HIV prevalence from PPTCT data was comparable to that from general population surveys. In all three states, significant declines in HIV prevalence between 2007 and 2010 were observed with the PPTCT data set. District level analyses of HIV trends and sub-district level analysis of HIV prevalence were possible using the PPTCT and not the HSS-ANC data sets.

Conclusion

HIV prevalence from PPTCT may be a better proxy for general population prevalence than HSS-ANC. PPTCT data allow for analysis of HIV prevalence and trends at smaller geographic units, which is important for decentralized planning of HIV/AIDS programming. With further improvements to the system, India could replace its HSS-ANC with PPTCT programme data for surveillance.     

Application of condoms on male clients by female sex workers in Yerevan, Armenia: prevalence and correlates

This study sought to assess the prevalence of consistent condom application on male clients by female sex workers (FSWs) in Armenia and its association with demographic, psychosocial and behavioural factors. In this cross-sectional study, 120 street-based FSWs aged 20-52 completed an interviewer-administered questionnaire. The primary outcome measure was consistent application of condoms by FSWs on their male clients. A total of 21.7% of participants reported consistently applying condoms on clients. Logistic regression analysis demonstrated that higher condom use self-efficacy (Adjusted Odds Ratio, AOR=1.1; p=0.01), lower perceived condom use barriers (AOR=0.9; p=0.04) and not using douching as a method to prevent STI/HIV (AOR=4.8; p=0.04) significantly predicted consistent condom application. Higher HIV/AIDS knowledge was a marginally significant predictor of condom application (AOR=1.3; p=0.05). Future interventions should address these modifiable factors to encourage FSWs to apply condoms on clients themselves, which may reduce condom failure and exposure to HIV transmission.     

Cross-cultural dimensions of breastfeeding practices and abstinence: Evidence from Uttar Pradesh and Tamilnadu, India

Summary and Conclusion The analysis contained in this paper brings out very clearly that the practice of breastfeeding and abstinence in the two major states of India: Uttar Pradesh and Tamilnadu are highly related to socio-cultural factors and changes in generational gaps. The findings reveal that literate, non-Hindu, and rich (high SLI) women have shorter breastfeeding durations than illiterates, Hindus, and poor (low SLI) women of Uttar Pradesh and Tamilnadu. In addition, the breastfeeding practice in Uttar Pradesh is influenced by residence background and generational age-gaps. The role of socio-cultural factors in influencing post-partum sexual abstinence period has been found to be significantly important through the variables; residence background, generational age-gaps, religion and working status of women. The results reveal that urban women, of younger cohorts (below 30 years), non-Hindu, and non-working women have shorter abstinence periods compared to rural women, of older cohorts (above 30 years), Hindus, and working women in both the states. The findings from this analysis suggest that apart from modernization process, defined in terms of higher literacy levels, higher developmental and urbanization levels, the changing perceptions and attitude towards lactational practices over the generation has significant dent on shortening of breastfeeding durations and abstinence periods. Thus, the study support the hypothesis that the process of modernization defined in terms of improvement in level of education, family income, urbanization tends to shorten the period of breastfeeding and abstinence, and consequently, the post-partum infecundability is reduced. Such reductions in the infertile periods can be expected to contribute to an increase in natural fertility levels of the population and also on the observed fertility levels, if not counter balanced by the fertility reducing effects of contraception.     

On the road: Croatian truck drivers, commercial sex and HIV/AIDS

The primary aims of this study were to examine Croatian truck drivers' sexual contact with sex workers, estimate the frequency of condom use, and assess knowledge of HIV/AIDS within this population. The research was conducted from June 14 to September 16, 2005 at customs offices and accompanying parking lots in four Croatian cities. The sample consists of 69 truck drivers. Information about sexual behavior and condom use were gathered by using a semi-structured interview. Knowledge of HIV/AIDS, measured with a self-administered questionnaire, was found to be low. Six respondents (8.7%) had correctly answered all 13 questions. By contrast, 73% of drivers considered themselves well informed about HIV/AIDS, indicating that most drivers overestimate their knowledge. The majority of respondents (n=62) assumed that most of their colleagues engage in sexual contact with sex workers while on the road, although only one third of respondents reported that they personally have paid for sex. All of the respondents who reported engaging in sexual contact with sex workers stated that they always use condoms. Fear of being infected with a sexually transmitted infection was reported as the main reason for condom use.     

The distribution of consecutive closed birth intervals in females in Uttar Pradesh

Most studies of closed birth intervals are regarding their variation at specific orders among females. This paper attempts to study the nature of the distributions of consecutive closed birth intervals. Data from the Uttar Pradesh National Family Health Survey 1998-99 (NFHS-2) were analysed. It was found that, under certain assumptions, the postpartum amenorrhoea period and menstruating interval are negatively associated, indicating that socio-cultural factors are affecting the menstruating interval.