Dr. Tapas Chakma Co-Investigator & Scientist –‘G’ Head of NCD-Division

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Dr. Tapas Chakma Co-Investigator & Scientist –‘G’ Head of NCD-Division 00 Principal Investigator & Scientist ‘B’ & Dr. Tapas Chakma Co-Investigator & Scientist –‘G’ Head of NCD-Division hh ICMR-National Institute of Research in Tribal Health (Indian Council of Medical Research) i | P a g e Jabalpur (Madhya Pradesh) Project Report On "HEALTH ASSESSMENT OF VILLAGERS OF TAMNAR BLOCK, DISTRICT RAIGARH (C.G.)” Submitted By Dr. Suyesh Shrivastava MBBS, MD (COMMUNITY MEDICINE) Principal Investigator & Scientist ‘B’ Mob- +919200265496, Phone- 0761-2370800 Email: [email protected] & Dr. Tapas Chakma MBBS, MAE, Co- Principal Investigator & Scientist ‘G’ Head, Division of Noncommunicable Disease (NCD) Email: [email protected] Project Coordinator Dr. Aparup Das Director and Scientist-G ICMR-NIRTH, Jabalpur, M.P. Submitted To Indian Council of Medical Research, New Delhi Year 2019-2020 ii | P a g e Team Members Principal Dr. Suyesh Shrivastava, MBBS, MD, Scientist ‘B’ Investigator Co- Principal Dr. Tapas Chakma, MBBS, MAE, Scientist ‘G’ Investigator Mr. Arvind Kavishwar, M.Sc, PGDCSA (Pr. Techn.Officer) Mr. Ashok Kumar Gupta, B.A., DMLT (Technical Officer B) Technical Staff Mr. Santosh Patkar, M.Sc, DMLT (Technician-II) Dr. Sirin Khan, BDS, MPH, Scientist B (Medical) Mr. Alok Kushwaha, Poly Diploma IT (DEO-A) Mr. Suneel Prajapati, B.Sc, DMLT (Technician ‘C’) Ms. Amrita Upadhayay, M.Sc, DMLT (Field Investigator) Project Staff Mr. Ankit Tirkey, M.Sc (Field Investigator) Mr. Mukesh Sahu, M.Sc, DMLT (Field Investigator) Mr. Sohan Lal Prajapati, B.Sc, DMLT (Field Investigator) iii | P a g e Acknowledgments We are thankful to the Padma Shri Dr. Balram Bhargava, Secretary, Department of Health Research and Director General ICMR, for the financial assistance of the project. We express our sincere gratitude to Dr. Rupinder Singh Dhaliwal Scientist-G & Head NCD division for assigning the project to us and their continuous support during the project. We take this opportunity to thank our Director, Dr. Aparup Das ICMR-National Institute of Research in Tribal Health Jabalpur for his guidance, support and encouragement during the entire period of the study. We would like to thank Dr. Pankaj V. Uike (Project Scientist-C) for help in conducting cause of death survey and Mr. Lalit Sahare, Technical Officer B for helping us on the laboratory analysis of stool samples. Further the team would like to express sincere thanks to District Collector Raigarh, CMHO Raigarh, BMO of Tamnar Block and Mr. Shriram Bhagat Rural Health Officer for their all out help during the survey. We would also like to thank HR Division Jindal Power Limited (JPL) for providing accommodation to the team during the study period. We will fail in our duty if we do not thank to all the ASHA (Mitanin)/ANM workers who immensely helped during household surveys and tribals who participated in the study. iv | P a g e List of Tables Part-A Health Assessment of villagers 1 Distribution of socio-demographic factors of villagers 52 2 Age and sex distribution of the study population 55 3 Prevalence of major morbidities among pre-school children 55 4 Prevalence of major nutritional deficiency disorders among pre-school 56 children 5 Prevalence of major morbidities among school going children 56 (6-14 yrs) 6 Prevalence of nutritional deficiency disorder among school going children 57 (6-14 yrs) 7 Prevalence of major morbidities among villagers (Age > 15 yrs) 57 8 Prevalence of nutritional deficiency disorder among villagers (Age > 15 yrs) 58 9 Gender-wise distribution of systolic blood pressure according to (JNC VII 58 Classification) 10 Gender-wise distribution of diastolic blood pressure according to (JNC VII 58 Classification) 11 Age group-wise distribution of systolic blood pressure among the villagers 59 12 Age group-wise distribution of diastolic blood pressure among the villagers 60 13 Distribution of systolic blood pressure according to Body Mass Index 61 14 Distribution of diastolic blood pressure according to Body Mass Index 61 1 5 Distribution of systolic blood pressure according to income status 61 16 Distribution of diastolic blood pressure according to income status 62 17 Distribution of hemoglobin level according to age category among the 62 villagers 18 Percentage distribution of anaemia according to hemoglobin level among 63 pregnant women 19 Percentage distribution of worm infestations in school going children 63 20 Gender-wise percentage distribution of BMI as per James et al. classification 64 among the villagers 21 Percentage distribution of children according to SD Classification 64 22 Status of immunization coverage among children upto 5 years 65 v | P a g e 23 Distribution of immunization status among child of 12-23 months 65 24 Distribution of health services utilization: Antenatal care 65 25 Distribution of iron folic acid tablet supplementation 66 26 Distribution of health services utilization: Postnatal care 66 27 Distribution of households aware of Government Health program facilities 66 28 Distribution of household availing Pradhan Mantri Ujjwala Yojana 66 29 Percentage distribution of fluoride level in urine 67 30 Percentage distribution of fluoride level (> 2.1 PPM) in urine 67 Part-B Causes of death 1 Socio-demographic characteristics of adults 68 2 Socio-demographic characteristics of neonates 69 3 Socio-demographic characteristics of children 69 4 Causes of death - associated risk factors 70 5 Causes of death among adults according to four major categories as per ICD 71 10 6 Distribution of deaths in four major categories by gender 71 7 Distribution of deaths in four major categories by age category, 71 8 Overall distribution of causes of deaths as per ICD 10 categories 72 9 Causes of death by age category as per ICD 10 categories 73 10 Overall and gender-wise distribution of causes of death in the ICD 10 74 categories 11 Proportion of deaths in four major categories according to smoking status 76 12 Proportion of deaths in four major categories according to alcohol use 77 13 Proportion of deaths among neonates as per ICD 10 category 77 14 Place of deaths among neonates 77 15 Proportion of deaths among child as per ICD 10 category 78 16 Place of deaths among children 78 vi | P a g e List of Figures Sr. Title Pg. No. No. 1 Age group-wise distribution of systolic blood pressure among the villagers 59 2 Age group-wise distribution of diastolic blood pressure among the villagers 60 3 Percentage distribution of anaemia among women (above 15 years of age) 63 4 Age-sex distribution of deceased in cause of death survey 34 5 Pre-existing diseases of the deceased 35 6 Cause of deaths according to four major categories 35 7 Overall distribution of cause of death 36 8 Cause of death according to sex distribution 37 9 Distribution of deaths according to age category 38 vii | P a g e Acronyms ANM Auxiliary Nurse Midwife ADA American Diabetes Association ASHA Accredited Social Health Activist BPL Below Poverty Line CDC Center for Disease Control and Prevention CD Community Development Block CG Chhattishgarh CGHR Center for Global Health Research CHC Community Health Centre COPD Chronic Obstructive Pulmonary Disease DBP Diastolic Blood Pressure DH District Hospital DM Diabetes Mellitus DOTS Directly observed treatment, short course DPT Diptheria, Pertussis and Tetanus g/dL Grams per decilitre Hb Hemoglobin HH Household HT Hypertension IHD Ischemic Heart Disease IDSP Integrated Disease Surveillance Programme ICD International Classification of Diseases JNC Joint National Committee JSY Janani Suraksha Yojana MO Medical Officer M.leprae Mycobacterium leprae µL Microliter NCD Noncommunicable Disease NCHS National Center for Health Statistics NFHS National Family Health Survey NIRTH National Institute of Research in Tribal Health NNMB National Nutrition Monitoring Bureau mmHg Milimeters of Mercury OPV Oral Polio Vaccine PHC Primary Health Centre PPS Probability Proportional to Size RBS Random Blood Sugar RGI Registrar General of India RNTPC Revised National Tuberculosis Control Program SBP Systolic Blood Pressure SPSS Statistical Package for the Social Science ST Scheduled Tribes TB Tuberculosis TT Tetanus Toxoid TISAB Total ionic strength adjustment buffer UT Union territory VA Verbal Autopsy WHO World Health Organization viii | P a g e Executive Summary Title: Health Assessment of Villagers of Tamnar Block, District Raigarh, Chhattisgarh Introduction: The morbidity profile provides an integral picture of the health and related conditions of any population. It helps in determining the priorities and accordingly in planning the nature and extent of health services to be provided on the available resources for achieving the desired result. Rational: A letter was received from Ministry of Environment and Forest and Climate Change, on the directives of National ST Commission to undertake a Study on Health Assessment and Projection of Health of People living in Tamnar Block, Raigarh, Chhattisgarh. Hence, the study was carried out to assess the Health & Nutritional status and cause of death among the tribe residing in Tamnar. Since, this is the first such study undertaken in this area. The study will help the local government in planning specific health programmes in this area and will also help in formulating disease-specific in-depth study later on. Objective: In this study, an attempt was made to find out the morbidity, mortality and nutritional status of the population residing in Tamnar Block of Raigarh District. Specific objectives were: 1. To study morbidity profile of the tribe residing in Tamnar Block of Raigarh District. 2. To assess the nutritional status through anthropometry 3. To assess the utilization pattern of various government health programmes by the community. Methodology: The study was carried on the directives of the National ST Commission in 33 sampled villages of Tamnar Block. The investigation included collection of data on demographic and socio-economic particulars of the households, anthropometry; clinical examination for general morbidity and nutritional deficiency disorders.Pulse, Blood Pressure, Random Blood Sugar were measured. Anthropometry like height was measured by SECA anthropometric rod, Weight was measured by a digital weighing scale by trained investigators.
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