Aparajita Dasgupta

Menstrual Hygiene: How Hygienic is the Adolescent Girl?

Background: Menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions resulting in adolescent girls remaining ignorant of the scientific facts and hygienic health practices, which sometimes result into adverse health outcomes. Objectives: (i) To elicit the beliefs, conception and source of information regarding menstruation among the study population and (ii) to find out the status of menstrual hygiene among adolescent girls. Materials and Methods: A descriptive, cross-sectional study was conducted among 160 adolescent girls of a secondary school situated in the field practice area of Rural Health Unit and Training Center, Singur, West Bengal, with the help of a pre-designed and pre-tested questionnaire. Data were analyzed statistically by simple proportions. Results: Out of 160 respondents, 108 (67.5%) girls were aware about menstruation prior to attainment of menarche. Mother was the first informant regarding menstruation in case of 60 (37.5%) girls. One hundred and thirty-eight (86.25%) girls believed it as a physiological process. Seventy-eight (48.75%) girls knew the use of sanitary pad during menstruation. Regarding practices, only 18 (11.25%) girls used sanitary pads during menstruation. For cleaning purpose, 156 (97.5%) girls used both soap and water. Regarding restrictions practiced, 136 (85%) girls practised different restrictions during menstruation. Conclusions: Menstrual hygiene, a very important risk factor for reproductive tract infections, is a vital aspect of health education for adolescent girls. Educational television programmes, trained school nurses/health personnel, motivated school teachers and knowledgeable parents can play a very important role in transmitting the vital message of correct menstrual hygiene to the adolescent girl of today.

Feeding practices of children in an urban slum of Kolkata

Good nutrition forms the basis for good health of a child. Nutrition is required for a child to grow, develop, stay active, and to reach adulthood as well.(1) Exclusive breastfeeding (EBF) is recommended as the optimum method of feeding for the first 6 months of life and semi-solid foods are to be introduced after 6 months while continuing breastfeeding to meet the physiological requirements of the infants.(2) Studies(3) have reported that the practices of early introduction of top feeds and late introduction of semi-solids are widely prevalent, more so in urban slums. Studies by the Nutrition Foundation of India (NFI) in urban slums of three major cities (Mumbai, Kolkata, and Chennai) revealed serious erosion of breastfeeding practices. Other studies from urban slums repeatedly documented that exclusive breastfeeding was practiced in only 30-40% of infants, colostrum was discarded in upto 90%, use of prelacteal feeds was almost universal, use of feeding bottles, animal milk, and commercial milk formulae was very common. Also it was found that the introduction of complementary foods is markedly delayed and the foods lack the consistency, energy density and are fed in inadequate amounts and in unhygienic ways.(3) With this background, the study had been conducted to assess the feeding practices of the children in an urban slum and to determine the factors influencing it, if any.

Telemedicine: A New Horizon in Public Health in India

Telemedicine is the use of electronic information to communicate technologies to provide and support healthcare when distance separates the participants.(1) “Tele” is a Greek word meaning “distance “and “mederi” is a Latin word meaning “to heal”. Time magazine called telemedicine “healing by wire”. Although initially considered “futuristic” and “experimental,” telemedicine is today a reality and has come to stay. Telemedicine has a variety of applications in patient care, education, research, administration and public health.(2) Worldwide, people living in rural and remote areas struggle to access timely, good-quality specialty medical care. Residents of these areas often have substandard access to specialty healthcare, primarily because specialist physicians are more likely to be located in areas of concentrated urban population. Telemedicine has the potential to bridge this distance and facilitate healthcare in these remote areas.(3,4)

Assessment of Malnutrition Among Adolescents:Can BMI be Replaced by MUAC

Objectives: To find out the magnitude of malnutrition among the adolescents of an urban slum of Kolkata study population. To compare the middle upper arm circumference (MUAC) with that of body mass index (BMI) for determination of nutritional status of the study population. Materials and Methods: This was a school-based descriptive epidemiological study done among adolescent male students aged 10–19 years in the service area of Urban Health Centre, Chetla. The school is an all boy’s government aided school and all the students reside in the Chetla slum, the largest slum of Kolkata. Anthropometric measurements of the students of one section selected from each class i.e. class V to XII were recorded. Results: Results showed 47.93% of study population as per BMI and 60.30% as per MUAC were malnourished. Evaluation of screening test showed MUAC as a marker was 94.6% sensitive and 71.2% specific. A correlation between measurements of MUAC and BMI was demonstrated (r=0.822; SE=0.035; 95% CI; P=0.000000; r2=0.74).

Disclosure among people living with HIV/AIDS

The prevention and control of human immunodeficiency virus (HIV) infections depends on the success of strategies implemented to prevent new infections and to treat currently infected individuals. Voluntary HIV testing and counselling can serve both the goals by enabling healthy individuals to remain uninfected and those infected to plan their future and to prevent HIV transmission to others. Disclosure of the HIV status to ones sexual partner is an important prevention goal emphasized by the WHO and CDC in their protocols for HIV counselling and testing. Disclosure offers a number of important benefits to the infected individual and to the general public. Disclosure of HIV test results to ones sexual partner is associated with less anxiety and increased social support. In addition it may lead to improved access to HIV prevention treatment opportunities for risk reduction and planning for the future. Moreover risk behaviours change most dramatically among couples where both partners are aware of their HIV serostatus. It also enables couples to make informed reproductive health choices which may ultimately lower the number of unintended pregnancies among HIV/AIDS positive women. Among the risks of disclosure of HIV serostatus are loss of social economic and emotional support blame abandonment discrimination and disruption of family relationships. This leads to loss of opportunities for the prevention of new infections and the ability to access appropriate care treatment and support services. (excerpt)

Relationship of personal hygiene with nutrition and morbidity profile: a study among primary school children in South Kolkata.

Background: Majority of the health problems affecting school children are preventable by promotion of hygienic practices through proper health education by the teachers, who are the first contacts. Objectives: The study was undertaken to find out the status of nutrition and personal hygiene among primary school children and their association with their varied morbidity profiles. Materials and Methods: A descriptive, observational, cross-sectional study was conducted in a primary school situated in the largest slum of Kolkata. Results: The participants included 103 boys and 81 girls, with a mean age of 6.2 years. The mean personal hygiene score of the girls (4.15 ± 0.98) was significantly higher than that of boys (3.2 ± 1.4) [P<0.05]. Most of the boys (54.37%) and girls (74.07%) were normally nourished as per the CDC growth chart. Over 70% of the children were suffering from one or more morbidities, the most common morbidity in both the sexes being pallor, followed by worm infestation. Personal hygiene scores were significantly higher (P<0.05) among those children who were normally nourished as well as those who did not suffer from any morbidity in the last 15 days. Conclusions: Care should be taken to improve the pitiable state of personal hygiene and poor sanitary practices of these school children through coordinated and concerted health education measures by teachers as well as parents.

Licit and illicit substance use by adolescent students in eastern India: Prevalence and associated risk factors

Background: Use of tobacco, alcohol, and other substances is a worldwide problem and affects many adolescents. Objective: (1) To find out the magnitude of licit and illicit substance use among students; and (2) to find out the association between socioeconomic and demographic characteristics of the students and habits of use. Materials and Methods: This was a population-based cross-sectional study conducted during June 2003 to May 2004. In a multistage random sampling among all the districts and schools in West Bengal, India, 416 high school students from two schools were selected. The main outcome measures were substance use, namely, tobacco, alcohol, and cannabinoids. From the schools, all the students in the classes VIII, IX, and X were taken as the study population and were administered a pretested close-ended anonymous self-administered questionnaire relating to pattern, frequency, and correlates of substance use. Results: The ultimate response rate was 87.02% and 416 students could be covered in our study. The overall prevalence rates among rural and urban students were 6.14% and 0.6% for illicit drug use, 8.60% and 11.04% for tobacco, and 7.37% and 5.23% for alcohol consumption, respectively. Both licit and illicit substance use was associated more with male students. Current and regular use were mostly restricted to tobacco, and the use of a substance by family members had a significant impact on its use by their children. “Enjoyment” and “Curiosity” were found to have the major influence in their decision to use a substance. Conclusions: Early identification of the magnitude and the factors related to substance use can improve scopes for planning and preventive approaches for this vulnerable group before the problems get serious after which interventions become difficult.

Substance use among adolescent high school students in India: A survey of knowledge, attitude, and opinion

Background: Is knowledge regarding the consequences of substance use among adolescents enough to prevent them from initiating and continuing its use, is a question that needs to be clarified further? Objective: To assess the knowledge regarding harm of use and to obtain information about attitudes among high school students. Also, to discover the opinion of substance use held by users. Materials and Methods: This was a population based cross-sectional study conducted in two high schools of West Bengal, India, among 416 students, in classes VIII, IX, and X, with no interventions. Primary outcome measurements were substance use: knowledge regarding harm, attitude, and opinion. Following this proportions and the chi-square test were used for statistical analysis. Results: Out of 416 students, 52 (12.5%) used or abused any one of the substances irrespective of time and frequency in lifetime; 26 (15.1 %) were among the urban students and 26 (10.7 %) were among their rural counterparts. More than two-thirds (73.07%) of the respondents expressed a desire to quit substance use and 57.69% had tried to stop. ‘Easy availability’ and ‘relief from tension’ were the most frequent reasons for continuation of substance use. Level of knowledge on harmfulness of substance use among students was very high (urban — -84.6% and rural — 61.5%) and they stated media as the most frequent source of information. Users were successful in influencing their peers into taking up this habit (urban — 15.4% and rural — 26.9%). Conclusions: Inspite of being aware of the harmful effects of substance use, adolescents take up this habit. This requires comprehensive prevention and control programs in schools and the community, targeted toward adolescents and their parents and other family members. Effective measures are required to encourage shaping the attitude of school children toward self-confidence and adequacy, as also to prevent risk behavior among adolescents.

Health status of workers engaged in the small-scale garment industry: How healthy are they?

Though India is now considered a major power and is turning into a developed country from a developing country, a large section of its population still belong to the poorest of the poor. In developing countries, great efforts are directed towards the advancement of small-scale industries as these are considered the engine for their economic growth. According to WHO, over 1000 million people worldwide are employed in small-scale industries.(1) The ‘garment’ industry of India is one such industry. It is an unorganized sector, mostly run by private establishments. It provides employment for both men and women, mainly those from the lower socioeconomic classes. The employees of this industry hardly ever benefit from occupational health-and-safety provisions. As a result their health suffers.(1) Studies show that musculoskeletal problems, diseases of the respiratory system and eye, accidents, injuries, skin diseases, stress, insomnia, etc. are all common among these workers. The ill health is compounded by various socioeconomic factors such as poverty, lack of education, poor working conditions, excess working hours, and poor diet.(2–4) Against this background, and because no such study has been carried out in this part of the country to date, we conducted this study among workers employed in the ‘garment’ industry; we had the following objectives: To find out the morbidity profile of the workers with special reference to musculoskeletal disorders. To assess the relationship of socio-demographic and occupational factors with the musculoskeletal disorders. To assess the felt needs of these workers. Materials and Methods This was a community-based cross-sectional study carried out in a slum area of Kolkata. The study was conducted from September 2008 - November 2008. There are three main areas in the slum where almost all those engaged in the small-scale garment industry reside. One such area was chosen by simple random sampling. A complete enumeration of all workers in the chosen area was done. There were one hundred and twelve such workers who were identified and all of them consented to participate in the study. The subjects were then interviewed using a predesigned, pre-tested, semi structured questionnaire that had been translated into the local language; the questionnaire collected data on socioeconomic conditions, occupational history, health problems. The felt needs of the workers were obtained from two Focus Group Discussions in each of which 9 workers participated. The researchers organized the group discussions after assuring confidentiality to the participants. Efforts were made to elicit the problems faced by them at their place of work, dealings with their employer and the changes they would like for a better and conducive working environment.

Sexual practice and perception of HIV/AIDS amongst men who have sex with men in Kolkata.

Background and Objectives: Men who have Sex with Men (MSM) are a vulnerable population and need special attention in the fight against the global pandemic of HIV/AIDS. A study was conducted in an MSM clinic to find out to their varied socio-demographic characteristics, their knowledge and attitude towards HIV/AIDS, and its association with their different sexual practices. Materials and Methods: Descriptive, cross sectional study conducted in an MSM clinic in central Kolkata. Results: A total of 108 MSM were studied over a period of six months. A majority (25%) were students, followed by drivers (22.2%), with mean age being 22.8 years. About 13.9% of them were illiterate and 30.6% of them married. A majority (75%) of the clients were initiated to first sexual act during adolescence. Most (44%) of them had indulged in sexual acts with two/three partners in the past one month. The most common form of sexual act was receptive anal sex (83.3%). The commonest reasons for indulging into such sexual acts with men were increased pleasure to have sex with men and increased sexual urge (38.9% and 27.8%) while 19.4% performed such acts in an intoxicated state. Only 22.2% ever used condom in the last one month during sexual acts. Their knowledge and positive attitude towards HIV/AIDS increased significantly with increase in literacy status (P less than 0.01). Only 36 (33.3%) knew about HIV transmission through anal route while only 35.2% knew the correct method to use condom. Favorable sexual practices like using a condom or having fewer partners was more among the literates than the illiterates (P less than 0.05). Alarmingly 44.4% felt that one should have sex without a condom if his sex partner was extremely attractive, 88.9% felt that using a condom was not necessary if his partner was clean and hygienic, 69.4% felt that anal sex is for fun, so no condom is required while 43.5% felt getting HIV was a matter of bad luck. Conclusion: Proper IEC to promote condom use and promotion of safe sexual practice among MSM is the need of the hour.