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Biomedical subjects

H M Swami

Publications and source records attributed to H M Swami.

At least 19 recordsLinked to original sources
PubMed2006

Socio-demographic correlates of breast-feeding in urban slums of Chandigarh.

RESEARCH QUESTION: Whether socio-demographic factors are associated with initiation of breast-feeding in urban slums of Chandigarh. OBJECTIVES: (1) To study the prevailing breast-feeding practices adopted by mothers, (2) To study the socio-demographic factors associated with initiation of breast-feeding. STUDY DESIGN: Cross-sectional. PARTICIPANTS: Mothers of infants willing to participate in the study in the selected area. SAMPLE SIZE: A total of 270 respondents. STUDY VARIABLES: Social and demographic characteristics like age, socioeconomic status, educational level, birth interval, parity, gender preference, natal care practices, etc.; and variables related to various aspects of breast-feeding practices like prelacteal feed, initiation of feeding, colostrum feeding, reasons of discarding colostrum, etc. STATISTICAL ANALYSIS: Chi-square test and odd ratios along with their respective 95% confidence intervals, multiple logistic regression analysis. RESULTS: Out of all 270 respondents, 159 (58.9%) initiated breast-feeding within 6 h of birth, only 43 (15.9%) discarded colostrum and 108 (40.0%) mothers gave prelacteal feed. Illiterate/just literate mothers who delivered at home were found at significantly higher risk of delay in initiation of breast-feeding on the basis of multiple logistic regression analysis. SUGGESTIONS: Promotion of institutional deliveries and imparting health education to mothers for protecting and promoting optimal breast-feeding practices are suggested.

Adult↗
PubMed2005

Condom-promotion programme among slum-dwellers in Chandigarh, India.

This study describes high-risk behaviour and condom usage in inhabitants of an urban slum in the Union Territory of Chandigarh, which has a population of about 20,000. A cohort of 375 participants was followed-up before and after an intervention. Half of the married but only one-eighth of the unmarried slum dwellers were using condoms regularly. One-quarter of the study subjects practised high-risk behaviour and this was higher among unmarried (44.88%) than married participants (18.7%). An intervention involving education on condom use and provision of free condoms increased the condom usage rate from 31.73% in the pre-intervention phase to 60% in the postintervention phase.

Adult↗
PubMed2005

Operationalisation of surveillance of communicable diseases in Chandigarh.

Weekly reports of listed communicable diseases from various departments and centres of Government Medical College, Chandigarh, involved in clinical care and laboratory diagnosis, compiled and forwarded by Department of Community Medicine, sub-nodal centre under National Surveillance Programme for Communicable Diseases (NSPCD), to Anti- Malaria-cum-Nodal Officer, NSPCD were analysed for a period of one year Out of 14,082 cases of various communicable diseases 9166 (64.62%) were of Acute Respiratory Infections (ARI), 3586 (25.78%) of Acute Diarrhoeal Diseases (ADDs) and 576 (4.10%) of Pulmonary Tuberculosis. The proportion of ARI appeared higher among females while that of other diseases was higher among males. Most cases of ARI (76.5%) and Pneumonia (3.09%) reported in winter, ADDs (38.89%) and Pulmonary Tuberculosis (4.68%) in summer and Typhoid (1.57%) and Viral Hepatitis (1.23%) in monsoon season. No significant gender predilection was seen. Overall reporting of communicable diseases seen to be significantly more during winter and summer compared to monsoon season, with specific seasonal trends demonstrated by various morbidities.

Communicable Disease Control↗
PubMed2004

Immunization status in children.

OBJECTIVE: Recent studies and surveys are observing a declining trend of routine immunization coverage and fully immunized children in India are reported to be 38%. A rapid assessment technique was used on National Immunization Day (PPI) to assess the immunization status among children in the age group of 12-23 months covering urban, rural and slum areas in UT, Chandigarh. METHODS: The study covered 796 children in proportion of their distribution in urban, rural and slum areas. RESULTS: Evaluation recorded fully immunized children as 72.23%, partially immunized as 22.99% and unimmunized as 4.64%. Only 58.66% children in urban slums were fully immunized. The overall coverage for various vaccines was BCG: 93.09%, DPT1/OPV1: 93.97%, DPT2/OPV2: 90.57%, DPT3/OPV3: 85.92% and measles: 76%. No sex-wise difference was noticed in the study. CONCLUSION: Efforts must be made to strengthen routine immunization programme especially in the underprivileged groups and areas such as slum in cities so that target of universal coverage can be achieved as envisaged at national level.

Female↗
PubMed2004

Outbreak of measles amongst vaccinated children in a slum of Chandigarh.

BACKGROUND: An outbreak of measles was reported from a slum, UT, Chandigarh in April 2003. Similar outbreak was also reported in less than three years from the same and adjoining areas. The present study was conducted to investigate and assess various epidemiological features associated with measles outbreak. MATERIAL AND METHODS: Three cases of measles were admitted in Dept. of Paediatrics, Govt. Medical College & Hospital, Chandigarh and were reported to the Dept. of Community Medicine for an outbreak investigation. A trained team investigated the slum having a population of 25,000 and studied various features associated with epidemic between the period of April 22 to May 10, 2003. RESULTS: The study covered 484 houses having 1130 children. Among the children who developed measles 32.76% were vaccinated ones. In them attack rate was 3%. Attack rate in vaccinated children went on increasing as age increased. An overall attack rate of 5.13% (Peak incidence 6% in 1-4 years age group) was recorded. Among measles cases, one-fifth had post measles complications. As much as 32.76% children with measles had received measles vaccination in the past. Therefore something more than immunization by single dose of vaccine is required. Measles was reported to be higher amongst the children without Vitamin A supplementation (P < 0.001). CONCLUSION: There is need to store vaccine properly and to strengthen routine immunization coverage, Vitamin A supplementation and health infrastructure in underprivileged population. Serological studies among vaccinated children against measles should be undertaken to explore the possibility of second dose of measles in older children.

Adolescent↗
PubMed2004

Improving environmental conditions of a slum in Chandigarh by an awareness campaign.

An intervention project, in the form of an environmental awareness campaign was conducted in a slum of Chandigarh with a population of about 40,000, from December 1998-April 1999. The activities enforced during this campaign included focus group discussions with general public and mothers, household visit by medical students, distribution of literature, use of mass media by involving local residents, primary child care workers, teachers and school children. Evaluation of this campaign was carried out in May 1999 and compared with the baseline data obtained from a survey done in 1997. The study revealed that the method of storing water in covered buckets and utensils had improved significantly from 14.3% and 4.7% in the baseline survey to 35.2% (P < 0.001) and 16.2% (P < 0.01) respectively. Refuse disposal in the community bin and own bin had significantly improved to 22.2% (P < 0.001) and 19% (P < 0.01) from 8.4% and 11.2% respectively in the baseline survey. 51.2% of the residents using own bins disposed the refuse finally into the community bin. The use of community latrines had significantly increased among males (50.0%), females (47.7%) and children (41.2%) after intervention as compared to 32.8%, 32.5% and 16.7% respectively as found in the baseline survey (P < 0.001) and similarly open defaecation had significantly reduced among them. Further the study shows that the awareness regarding diarrhoea as hazard of unsafe water had improved significantly from 28.7% in baseline survey to 55.6% after intervention (P < 0.001). Knowledge of the residents regarding hazards of refuse disposal in the open and open defaecation had also improved significantly. Simple environmental awareness campaign can change the knowledge and behavioural practices of slum dwellers and could be a model for launching similar projects in other slums of India and other developing countries.

Adult↗
PubMed2003

Social and functional status of older persons in a north Indian community.

With increase in life expectancy, the geriatric population is growing in developing countries. The Union Territory of Chandigarh has a population of about 0.9 million with nearly 90% in urban and 10% in rural areas. This cross-sectional, descriptive study was conducted in Chandigarh over a period of one year; 1998-99 among 362 subjects 65 years or more of age covering a population of 7937 family members in 1882 houses. The sampling was done by random sampling technique covering urban and rural population. The proportion of older persons in Chandigarh comprised 5.47% of the population. Most of the respondents were living with their spouses. More than one-fifth of urban and two third of rural older persons were illiterate. About 86% were living with their families and only 3.6% were living alone. Major modes of recreation were visiting religious places by two-thirds followed by going to parks and gardens by nearly one-fourth. Among 203 older persons having living partners in the study, one in every fifth older persons had indulged in sexual intercourse in the past six months. Nearly 2% of older persons needed assistance (partial or full) in activities of daily living like bathing, dressing, toileting, feeding, continence etc. The study also observed rural and urban variation in the use of aids and appliances by older persons. On the basis of very few having functional limitations, there is a need to include components of recreational facilities, activities of daily living, and not just assistance and aids and appliances, while developing a comprehensive geriatric health care programme in developing countries.

Activities of Daily Living↗
PubMed2002

Mass supplementation of vitamin A linked to National Immunization Day.

OBJECTIVE: Main objectives were to assess the feasibility of linking vitamin A delivery with National Immunization Days (NIDs) and to see the impact on xerophthalmia. METHODS: An Intervention study of mass distribution of vitamin A solution was undertaken to control widespread xerophthalmia prevalent in children living in about 26 slums of Chandigarh in the year 2000. Two rounds of mass distribution of Vitamin A solution covering 27642 and 31762 children in 1-5 years of age in first and second rounds, respectively, were undertaken. The findings of second round and post evaluation after intervention are presented here. An additional team of two persons per pulse polio immunization (PPI) centre delivered age specific doses of vitamin A solution through 98 centres and operational problems were recorded. PPI staff provided the supervision and PPI tally sheets were used. RESULTS: The programme achieved a vitamin A coverage rate of 99% in first round and 88% in second round. Only two parents refused vitamin A solution. No side effect or cases of toxicity due to vitamin A were reported by health institutions in the area or in a stratified random sample of 101 children. There was a significant decline (13.4%) in xerophthalmia after two rounds of mass distribution (P < .001). The strategy to deliver vitamin A was successfully integrated into NID's and appeared to achieve a significant decline in xerophthalmia. CONCLUSION: Linking of vitamin A distribution with PPI could be a basis for launching similar initiatives in other areas of India and other countries where xerophthalmia is a public health problem.

Dietary Supplements↗
PubMed2002

Measles outbreak in a Periurban area of Chandigarh: need for improving vaccine coverage and strengthening surveillance.

OBJECTIVE: An outbreak of measles was investigated in the periurban areas of Chandigarh Union Territory, during the months of December 1998 to February 1999. Mainly the children below 15 years of age were affected. The children of migrant labourers belonging to the neighbouring states of Uttar Pradesh and Bihar constituted the majority of population in the area under study. They belonged to lower socio economic status with low immunization coverage. METHODS: A total of 2968 houses were surveyed for epidemiological investigations in the areas of colony No. 5, Ramdarbar, Palsora and Pandit colony of Kajheri, covering a population of 14,601 and 7.3% (216/2968) of families were affected in the outbreak. RESULTS: Two hundred and eighty three cases of measles were reported with an attack rate of 4.5% and male to female ratio of (M:F) 5.3%:3.6%. Among the measles cases, 48.8% had received measles vaccination. The outbreak was investigated by detecting measles specific IgG/IgM antibodies either in acute or convalescent serum samples or both. Due to inadequate surveillance system and containment measures, the outbreak was in full swing during the winter months. Measles related complications were reported in 31.1% cases (i.e. diarrhoea in 15.2% and Pneumonia is 7.1%). CONCLUSION: Following smallpox and guinea worm eradication, WHO's next thrust, is on eradication of poliomyelitis and measles. Hence, strengthening of disease surveillance as well as vaccination policies are mandatory to achieve disease control in these areas.

Adolescent↗
PubMed2002

Population based study of hypertension among the elderly in northern India.

The study was conducted in the urban and rural areas of Chandigarh during 1998-1999 among 362 elderly subjects above 65 y of age. The sample, selected by stratified random technique, covered a population of 7937 family members in 1882 houses. Methodology comprised of interviews, clinical examination and laboratory investigations such as ECG. The study revealed that 210 (58%) of the elderly were hypertensives. Of the hypertensives, only 39% are on medication. Fewer calories were consumed by the hypertensives. Further, 82.4% of the obese subjects were hypertensives as compared to 52.4% of the non-obese subjects (P<0.001). Only 56 subjects (27.6%) were both diabetic and hypertensive. One third of the elderly had some abnormality in ECG revealing associated coronary heart disease. Forty subjects (11.05%) had complications such as MI and stroke. The prevalence of complications was slightly higher (11.9%) in the hypertensives as compared to the non-hypertensives (9.9%). Thus health education campaigns should be started to increase awareness regarding the risk factors and bring about changes in lifestyle for the control of hypertension and reduction of its complications.

Aged↗
PubMed2001

Rapid assessment and delivery of Vitamin A to slum children by using National Immunization Day in Chandigarh.

This study was done with the objective to see the feasibility of using National Immunization Days (NIDs) for rapid assessment, and delivery of Vitamin A solution to about 27,600 children dwelling in 26 slums in Union Territory of Chandigarh. The assessment of Vitamin A deficiency (VAD) was done in a stratified random sample of 1304 children during third round of Intensified Pulse Polio Immunization (IPPI) and delivery of Vitamin A solution was done during fourth round of IPPI in 1999-2000 covering 27,642 children in the age group of 1-5 years. An additional team of two persons per centre delivered age specific doses of Vitamin A solution through 72 centres and operational problems were recorded. IPPI staff provided supervision and same tally sheets as of IPPI were used. The prevalence rate of VAD was 24.6%, with conjunctival xerosis, bitot's spot and corneal xerosis as 23.7%, 0.6% and 0.2% respectively. 27,275 (98.7%) children out of 27,642 were administered Vitamin A solution, with no major operational problem. Only five parents (0.01%) refused Vitamin A solution. No case of side effect or toxicity due to Vitamin-A was reported. The strategy to assess and deliver Vitamin A during NID's was found to be feasible and successful and could be a basis for launching similar initiatives in other areas of India and other countries where VAD is a public health problem.

Child, Preschool↗
PubMed2001

Nutritional status of pre-school children in an integrated child development service (ICDS) block of Chandigarh.

Nutritional status of 1286 pre-school children selected by a stratified random sampling and residing in urban, rural and slum areas of Chandigarh was assessed by weight for age criteria by making domicilliary visits. The overall prevalence of protein energy mulnutrition (PEM) was found to be 51.6% while 65.4%, 26.3%, 5.3% and 3% of children had grades I, II, II and IV PEM, respectively. The prevalence of malnutrition significantly increased with increase in age till 3rd year, then started declining (P<0.001). The prevalence of PEMwas significantly higher among Integrated Child Development Service (ICDS) beneficiaries (53.8%) than non-ICDS beneficiaries (46.9%); P<0.05. More attention and better impetus are required to be given to improve the nutritional status of pre-school children in Chandigarh.

Child Health Services↗
PubMed2001

Epidemiological investigation of cholera outbreak in a periurban slum colony in Chandigarh.

An investigation was carried out in a periurban slum colony in Chandigarh in September 1999 following a report of two microscopically confirmed cases of cholera admitted in Govt. Medical College Hospital, Chandigarh. Rapid survey in the colony covering a population of 1404 found that there were 14 cases of diarrhoea in the colony with attack rate of 9.97/1000 population. Majority (70%) of cases were females and 62% cases were under five years of age. Health education, ORS packets and medications were distributed to cases. Water sampling was also done and it was found that water from one of the hand pump was positive for V. cholerae 01 biotype El Tor serotype Ogawa. Closing of that hand pump and chlorination of drinking water in other parts of slum was recommended to higher health authorities, which was done immediately. Surveillance for diarrhoeal diseases was found to be poor. Provision of safe drinking water, improving sanitation and strengthening of disease surveillance is necessary for control of cholera and other diarrhoeal diseases in slum areas.

Child↗
PubMed2000

Staff awareness of oral polio vaccine vial monitor in Chandigarh.

This study highlights the awareness of pulse polio centre staff about polio vaccine vial monitor (VVM) during a National Immunization Day in Chandigarh. Out of the 79 staff members interviewed, only 53 (67%) had ever heard of the VVM and were further interviewed. Fifty (94.4%) staff members were aware that VVM is present on vaccine itself and majority (79.2%) told that it is the inner square with outer circle. Only half were aware of its function and 71.7% knew how to read it. It was observed that awareness among health staff [Health worker (F)/ANM] and volunteers was very poor. There is a need for effective training of staff before subsequent PPI to maintain an effective cold chain.

Awareness↗
PubMed2000

National immunization day to assess nutritional status of underfives in Chandigarh.

National Immunization Days (NIDs) are an additional opportunity to reach a large number of children and can be used to undertake additional activities beside immunization. This study highlights an attempt to assess nutritional status of under five children by using a NID. Seven thousand four hundred and thirteen underfives were selected randomly from urban, rural and slums areas of Chandigarh. Nutritional status was assessed by using weight for age criteria. Prevalence of protein energy malnutrition (PEM) was found to be about 42% while 22.7%, 14.5%, 4.1% and 0.7% children had grade I, II, III and IV PEM respectively. The prevalence of PEM was significantly higher among females (47.6%), in 1-3 years age group (53.80%), in slum area (67%) and children of labour class (60.5%) (p < 0.001). With increase in family size, the prevalence of malnutrition also significantly increased, and decreased with high literacy rate in parents (p < 0.001). The prevalence of PEM in present study (42%) was comparable to a community based survey (51.6%) among pre-school children of an ICDS block of Chandigarh. National immunization days can be successfully used to assess nutritional status of children. This approach can be used by others for screening common childhood problems, preparing normogram for a region or country, administering Vitamin A and educating mothers.

Child, Preschool↗